Quintanilla-García C, Zúñiga-Guajardo S

Idioma: Español
Referencias bibliográficas: 46
Paginas: 509-520
Archivo PDF: 85.79 Kb.

RESUMEN

Las incretinas son hormonas producidas en el tracto gastrointestinal en respuesta a la ingesta de alimentos y con efecto sobre las células de los islotes de Langerhans, que aumentan la secreción y liberación de la insulina y disminuyen la secreción de glucagón dependiendo de la glucosa circulante. Las principales incretinas son el GLP1 y el GIP. El “efecto incretina” consiste en la mayor liberación de insulina por el páncreas cuando el estímulo de glucosa es gastrointestinal, comparado a cuando el estímulo es endovenoso. Este efecto está alterado en pacientes con diabetes tipo 2. El efecto incretina se puede aumentar de dos formas: producir un GLP1 que no sea inactivado por DPP4, es decir, un análogo de GLP1; o inhibir a la enzima que desactiva a las incretinas mediante lo que se llama inhibidores de DPP4. Hay dos análogos de GLP1, exenatide y liraglutide, y algunos otros en investigación. Hay tres inhibidores de DPP4: sitagliptina, vildagliptina y saxagliptina. Con ellos se logrará mejorar la glucemia en pacientes con DM2 y, por lo tanto, la hemoglobina glucosilada, con un perfil de seguridad adecuado, baja posibilidad de hipoglucemias y sin incremento o disminución de peso en los pacientes.

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