Incretins in the ICU: is insulin on its way out?

Michelle A. Kovalaske, Gunjan Y. Gandhi

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Incretins such as glucagon-like peptide-1 (GLP-1) are gut-derived hormones that stimulate insulin secretion and suppress glucagon secretion, thus playing a key role in glucose homeostasis. While incretin mimetics and enhancers are approved for treatment of outpatients with diabetes, evidence is only starting to accumulate regarding the therapeutic potential of incretins in hospitalized patients. Small exploratory studies suggest that GLP-1 safely reduces hyperglycemia without causing hypoglycemia, a key advantage over insulin if efficacy is established in larger studies. Potential limitations include the need for a continuous infusion for delivery, attenuation but not normalization of glucose levels, increased deceleration of gastric emptying and nausea. The exact mechanism of action, dosing, adverse effects, patient subgroups that would be most suitable and safety of combination treatment with insulin remain to be studied. While promising, additional research is required studying effects on hard clinical endpoints.

Original languageEnglish (US)
Pages (from-to)161
Number of pages1
JournalCritical care (London, England)
Volume13
Issue number4
StatePublished - 2009

Fingerprint

Incretins
Glucagon-Like Peptide 1
Insulin
Glucose
Deceleration
Gastric Emptying
Glucagon
Hypoglycemia
Hyperglycemia
Nausea
Homeostasis
Outpatients
Therapeutics
Hormones
Safety
Research

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kovalaske, M. A., & Gandhi, G. Y. (2009). Incretins in the ICU: is insulin on its way out? Critical care (London, England), 13(4), 161.

Incretins in the ICU : is insulin on its way out? / Kovalaske, Michelle A.; Gandhi, Gunjan Y.

In: Critical care (London, England), Vol. 13, No. 4, 2009, p. 161.

Research output: Contribution to journalArticle

Kovalaske, MA & Gandhi, GY 2009, 'Incretins in the ICU: is insulin on its way out?', Critical care (London, England), vol. 13, no. 4, pp. 161.
Kovalaske, Michelle A. ; Gandhi, Gunjan Y. / Incretins in the ICU : is insulin on its way out?. In: Critical care (London, England). 2009 ; Vol. 13, No. 4. pp. 161.
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