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

靶向肠促胰素系统已成为治疗 2 型糖尿病的重要治疗方法。已开发出两种药物类别：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，这些疗法可改善血糖控制，同时降低 2 型糖尿病患者的体重（特别是 GLP-1 受体激动剂）和收缩压 (SBP)。此外，由于这些治疗的葡萄糖依赖性作用机制，低血糖的发生率相对较低（除非与磺脲类药物联合使用）。目前有两种 GLP-1 受体激动剂可用（艾塞那肽和利拉鲁肽），还有几种正在开发中。本综述考虑了短效和长效 GLP-1 受体激动剂的有效性和安全性。头对头临床试验数据表明，与短效对应物相比，长效 GLP-1 受体激动剂可产生更好的血糖控制。此外，这些长效 GLP-1 受体激动剂通常耐受性良好，暂时性恶心是最常报告的不良反应。