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Type: Journal article
Title: Incretins and the intensivist: what are they and what does an intensivist need to know about them?
Author: Plummer, M.
Chapman, M.
Horowitz, M.
Deane, A.
Citation: Critical Care (UK), 2014; 18(1):205-1-205-10
Publisher: BioMed Central
Issue Date: 2014
ISSN: 1364-8535
Statement of
Mark P Plummer, Marianne J Chapman, Michael Horowitz, and Adam M Deane
Abstract: Hyperglycaemia occurs frequently in the critically ill, even in those patients without a history of diabetes. The mechanisms underlying hyperglycaemia in this group are complex and incompletely defined. In health, the gastrointestinal tract is an important modulator of postprandial glycaemic excursions and both the rate of gastric emptying and the so-called incretin hormones, glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide, are pivotal determinants of postprandial glycaemia. Incretin-based therapies (that is, glucagon-like peptide- 1 agonists and dipeptidyl-peptidase-4 inhibitors) have recently been incorporated into standard algorithms for the management of hyperglycaemia in ambulant patients with type 2 diabetes and, inevitably, an increasing number of patients who were receiving these classes of drugs prior to their acute illness will present to ICUs. This paper summarises current knowledge of the incretin effect as well as the incretin-based therapies that are available for the management of type 2 diabetes, and provides suggestions for the potential relevance of these agents in the management of dysglycaemia in the critically ill, particularly to normalise elevated blood glucose levels.
Keywords: Animals
Diabetes Mellitus, Type 2
Blood Glucose
Glucagon-Like Peptide 1
Dipeptidyl-Peptidase IV Inhibitors
Rights: © 2014 BioMed Central Ltd.
DOI: 10.1186/cc13737
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