Hypoglycemic agent. It is an incretin mimetic and is a 39-amino-amidopeptide. Incretins, such as glucagon-like peptide-1 (GLP-1), increase glucose-dependent insulin secretion, improve ?-cell function, suppress inadequately increased glucagon secretion, and slow down gastric emptying after they enter the bloodstream from the intestine. Exenatide is a potent incretin mimetic, which causes an increase in glucose-dependent insulin secretion and has other hypoglycemic effects inherent to incretin, which allows for improved glycemic control in patients with type 2 diabetes.
The amino acid sequence of exenatide partially corresponds to the sequence of human GLP-1, as a result of which it binds and activates GLP-1 receptors in humans, which leads to increased glucose-dependent synthesis and insulin secretion from ?-cells of the pancreas with the participation of cyclic AMP and / or other intracellular signal ways. Exenatide stimulates insulin release from ?-cells in the presence of elevated glucose concentrations.
In terms of chemical structure and pharmacological action, exenatide differs from insulin, sulfonylurea derivatives, D-phenylalanine derivatives and meglitinides, biguanides, thiazolidinediones and alpha-glucosidase inhibitors.
Exenatide improves glycemic control in patients with type 2 diabetes due to the following mechanisms.
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