GLP-1 ANALOGUE ANTI DIABETIC MEDICINE DECREASE INTRA CRANIAL PRESSURE BESIDE OBESITY,BP & SUGAR

Prof Dr,DRAM,HIV /AIDS,HEPATITIS ,SEX DISEASES & WEAKNESS expert,New Delhi,India, +917838059592

A new researchers have said that Glucagon-like peptide-1 receptor agonists also known as GLP-1 receptor agonists or incretin mimetics are agonists of the GLP-1 receptor are used  to treat Type II Diabetic patients could be used as a novel new way to lower brain pressure.These medicine also reduce obesity and lower hypertension and also cause no hypoglycemia as seen with sulphonylureas bt may cause pancreatitis or cancer rarely.Approved GLP-1 agonists are exenatide (Byetta/Bydureon), liraglutide (Victoza),lixisenatide (Lyxumia), dulaglutide (Trulicity),albiglutide (Tanzeum).

   A traumatic brain injury, hydrocephalus, accumulated water in the brain, as well as stroke can cause growing pressure inside your skull which is a major feature of Idiopathic Intracranial Hypertension (IIH).IHH causes disabling daily headaches and severely raised pressure around the nerves in the eye.Just 10 minutes of dosing of GLP-1 agonist led to rapid and dramatic reduce brain pressure by around 44 per cent, the researchers said, adding that the effects lasted for at least 24 hours.

      Alexandra Sinclair, from the University of Birmingham said,"These findings are rapidly translatable into a new novel treatment strategy for IIH as GLP-1 agonists are safe and widely-used drugs used to treat diabetes and obesity."Sinclair added,"They are also potentially game-changing for other conditions featuring raised brain pressure, including stroke, hydrocephalus and traumatic brain injury."

     Current primary treatment in IIH is acetazolamide, which does not work well for many patients, with severe side effects.Sinclair said,"We are very excited that this novel treatment strategy could make a landmark change for future patient care."The researchers are now due to begin a clinical trial to test GLP-1 agonist drug in patients with raised brain pressure.

            In recent management of Diabetes,antidiabetic agents that offer improved glycemic control without increasing cardiovascular risk factors or rates of hypoglycemia are warranted. At present, many available treatments for type 2 diabetes fail to maintain glycemic control in the longer term because of gradual disease progression as β-cell function declines. Where sulfonylureas or thiazolidinediones (common oral antidiabetic drugs) are used, the risk of hypoglycemia and weight gain can increase.The development of new therapies for the treatment of type 2 diabetes that, in addition to maintaining glycemic control, could reduce body weight,blood pressure and hypoglycemia risk may help with patient management.

      After we eat sugar or take glucose intravenously,Insulin secretion is increased ,it is called Increting effect which is done by two natural Increting Hormones which play a role in the maintenance of glycemic control: glucose-dependent insulinotropic polypeptide and GLP-1 or Glucagon-like peptide,both of which have a short half-life because of their rapid inactivation by DPP-4 or dipeptidyl peptidase 4.So DPP-4 inhibitors or gliptins such as sitagliptin, vildagliptin, saxagliptin is a new class of medicine is very much practice  in control of Diabetes  which reduce endogenous GLP-1 degradation, thereby providing physiological or high levels of GLP-1which increase insulin secretion or control diabetes.

      Beside this they also inhibit glucagon release, but only when glucose levels are elevated thus offering the potential to lower plasma glucose while reducing the likelihood of hypoglycemia. Furthermore, gastric emptying is delayed ( and food intake is decreased after GLP-1 administration resulting to reduce obesity.Preclinical studies reveal other potential benefits of GLP-1 receptor agonist treatment in individuals with type 2 diabetes, which include the promotion of β-cell proliferation (12) and reduced β-cell apoptosis .

            These preclinical results indicate that GLP-1 could be beneficial in treating patients with type 2 diabetes. However, because native GLP-1 is rapidly inactivated and degraded by the enzyme DPP-4 and has a very short half-life of 1.5 min ,to achieve the clinical potential for native GLP-1, patients would require 24-h administration of native GLP-1. Because this is impractical as a therapeutic option for type 2 diabetes, it was necessary to develop longer-acting derivatives of GLP-1 which is now in market             exenatide (Byetta/Bydureon) is short acting but  liraglutide (Victoza),lixisenatide (Lyxumia), dulaglutide (Trulicity) are long acting more than 24 hrs half life.

              DPP-4 Inhibitors Linagliptin and teneligliptin are dipe ptidyl-peptidase (DPP)-4 inhibitors that do not require dose adjustment even in type 2 diabetes patients complicated by CKD or chronic kidney disease.