Targeting the incretin system has become an important therapeutic approach for treating type 2 diabetes. Two drug classes have been developed: glucagon-like peptide (GLP)-1 receptor agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors. Clinical data have revealed that these therapies improve glycemic control while reducing body weight (GLP-1 receptor agonists, specifically) and systolic blood pressure (SBP) in patients with type 2 diabetes. Furthermore, incidence of hypoglycemia is relatively low with these treatments (except when used in combination with a sulfonylurea) because of their glucose-dependent mechanism of action. There are currently two GLP-1 receptor agonists available (exenatide and liraglutide), with several more currently being developed. This review considers the efficacy and safety of both the short- and long-acting GLP-1 receptor agonists. Head-to-head clinical trial data suggest that long-acting GLP-1 receptor agonists produce superior glycemic control when compared with their short-acting counterparts. Furthermore, these long-acting GLP-1 receptor agonists were generally well tolerated, with transient nausea being the most frequently reported adverse effect.

中文翻译：

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长效胰高血糖素样肽1受体激动剂

靶向肠降血糖素系统已成为治疗2型糖尿病的重要治疗方法。已开发出两种药物：胰高血糖素样肽（GLP）-1受体激动剂和二肽基肽酶4（DPP-4）抑制剂。临床数据表明，这些疗法可改善2型糖尿病患者的血糖控制，同时减轻其体重（特别是GLP-1受体激动剂）和收缩压（SBP）。此外，由于这些疗法的葡萄糖依赖性作用机制，低血糖症的发生率相对较低（与磺酰脲类药物联合使用时除外）。当前有两种可用的GLP-1受体激动剂（艾塞那肽和利拉鲁肽），另外几种正在开发中。这篇综述考虑了短效和长效GLP-1受体激动剂的疗效和安全性。头对头的临床试验数据表明，长效GLP-1受体激动剂与短效同行相比具有更好的血糖控制能力。此外，这些长效GLP-1受体激动剂通常耐受性良好，短暂的恶心是最常见的不良反应。