2型糖尿病胰岛功能障碍与基于肠促胰素的治疗

Islet dysfunction in type 2 diabetes mellitus and incretin-based therapy

多项研究显示，胰岛细胞功能障碍（α细胞及β细胞）对2型糖尿病的发生发展起决定性作用。β细胞功能障碍主要表现为胰岛素分泌的缺陷，α细胞功能障碍则主要是进餐后胰升糖素的分泌未得到有效抑制。因此，胰岛功能障碍是2型糖尿病治疗的重要靶点。研究显示，基于肠促胰素的药物，包括胰升糖素样肽1（GLP-1）受体激动剂及二肽基肽酶4（DPP-4）抑制剂能恢复胰岛细胞对葡萄糖的敏感性，有效改善血糖控制。期待此类药物对胰岛功能改善的更多研究。

Several studies have demonstrated that the development of pancreatic islet α- and β-cell dysfunction is pivotal to the onset and progression of hyperglycemia in type 2 diabetes mellitus （ T2DM ） . Mealstimulated insulin secretion from β-cell is reduced and fails to meet the demands of the insulin-resistant state. In addition, glueagon production by α-cell, which normally maintains hepatic glucose production during fasting periods, is not suppressed. We all know that islet dysfunction is a critical target for T2DM treatment. Incretin-based therapies, including glucagon-like peptide-1 （ GLP-1 ） receptor agonists and dipeptidyl peptidase-4 （DPP-4） inhibitors, have been shown to be able to restore glucose sensitivity of islet cells and thus improve glycemic control. Nevertheless, their potential impact on islet function in humans remains uncertain and needs further more investigation.