| Abstract | Šećerna bolest tip 2 je jedan od vodećih uzroka smrti u suvremenom svijetu. Razina glukoze u
krvi je povezana sa razvojem kardiovaskularnih bolesti, bubrežnih bolesti, pretilosti i ostalih
bolesti koje proizlaze iz makrovaskularnih i mikrovaskularnih komplikacija šećerne bolesti tip
2. Antihiperglikemici su lijekovi izbora u terapiji hiperglikemije koji imaju dokazanu
djelotvornost u smanjenju povišene razine glukoze u krvi. Zbog pojavnosti ne adherencije u
terapiji i loše kontrole glikemije u krvi koristeći neke od antihiperglikemika poboljšanje
kvalitete života pacijenata oboljelih od šećerne bolesti tip 2 je svakodnevni cilj. GLP-1 agonisti
su antihiperglikemici koji svojim načinom i učestalošću primjene uz pozitivnu kliničku
značajnu djelotvornost i na druga tkiva u organizmu povećavaju adherenciju u terapiji i
učinkovito smanjuju povišenu razinu glukoze u krvi. Povećana zainteresiranost među
znanstvenicima za istraživanje GLP-1 agonista postoji zbog njihovog kvalitetnog djelovanja i
dodatnih mogućnosti koje ovi lijekovi posjeduju u liječenju pacijenata.
U radu se prikazuje farmakodinamika, farmakokinetika GLP-1 agonista. Navodi se utjecaj
GLP-1 agonista na: mikrovaskularne posljedice šećerne bolesti tip 2, makrovaskularne
posljedice šećerne bolesti tip 2, tjelesnu težinu, kardiovaskularnu sigurnost, renoprotekciju i
smanjenje razine glukoze u krvi. Komparativnom analizom te prikazom prikupljenih
znanstvenih radova, koji su korišteni u ovom istraživanju, rad propituje potrebu dodatnog
istraživanja GLP-1 agonista. Ovo je pregledni, teorijski rad, a obrađuje lijekove koji se koriste
u liječenju šećerne bolesti tip 2, jedne od najzastupljenijih bolesti u svijetu. Za izradu rada
koristi se sustavno pretraživanje literature prema temi i predmetu istraživanja, autorima i
časopisu. Pretraga literature se provodi putem online baza podataka: PubMed, UpToDate,
Cochrane i Elsevier. Koriste se još i stručni članci, smjernice, priručnici te podaci službenih
web-stranica važnih za temu istraživanja. Ključne riječi za pretraživanje baza podataka
sadržavaju sljedeće pojmove: GLP-1 agonist, type 2 diabetes, clinical, effect, cardiovascular,
importance, glucose. U literaturi su identificirani mogući mehanizmi djelovanja GLP-1
agonista na snižavanje glukoze u krvi te fizikalno-kemijska svojstva GLP-1 agonista zbog kojih
ovi lijekovi imaju velik značaj za kliničku praksu. Proučavaju se tipovi GLP-1 agonista, njihov
kemijski sastav, doze, svojstva i učinci važni za kliničku praksu u liječenju šećerne bolesti tipa
2 uz kritički osvrt.
Učinci GLP-1 agonista na ljudski organizam posljedica su njihovog mehanizma djelovanja u
kojem dolazi do interakcije s GLP-1 receptorom što dovodi do povećanja koncentracije
unutarstaničnog cikličkog adenozinmonofosfata. Lučenje inzulina ovisno je o glukozi i u
slučaju povišene koncentracije glukoze u krvi se luči inzulin iz β stanica Langerhansovih
otočića gušterače. GLP-1 agonisti smanjuju lučenje glukagona. Također djeluju i usporavanjem
želuca, čime se smanjuje apsorpcija glukoze iz hrane nakon obroka. Prikazane znanstveno
utvrđene činjenice govore o tome da su GLP-1 agonisti djelotvorniji od nekih drugih
antihiperglikemika i u smanjenju tjelesne težine, normalizaciji glikemije te zaštiti
kardiovaskularnog sustava, bubrežnog sustava i drugih tkiva u organizmu. Strukturiranim
pregledom ovaj rad omogućava brzo pronalaženje činjenica koje su važne za: pacijente oboljele
od šećerne bolesti tip 2, znanost, struku i kliničku praksu. |
| Abstract (english) | Type 2 diabetes is one of the leading causes of death in the modern world. The level of glucose
in the blood is associated with the development of cardiovascular diseases, kidney diseases,
obesity and other diseases resulting from macrovascular and microvascular complications of
type 2 diabetes. Antihyperglycemic drugs are the drugs of choice in the treatment of
hyperglycemia, which have proven effectiveness in reducing elevated blood glucose levels. Due
to the occurrence of non-adherence in therapy and poor blood glucose control using some
antihyperglycemic drugs, improving the quality of life of patients with type 2 diabetes is a daily
goal. GLP-1 agonists are antihyperglycemic drugs that, by their method and frequency of
administration, have a positive clinical effect on other tissues in the body and increase
adherence to therapy and effectively reduce elevated blood glucose levels. There is an increased
interest among scientists in the research of GLP-1 agonists because of their high-quality effects
and the additional possibilities that these drugs have in the treatment of patients.
The paper presents the pharmacodynamics, pharmacokinetics of GLP-1 agonists. The influence
of GLP-1 agonists on: microvascular consequences of type 2 diabetes, macrovascular
consequences of type 2 diabetes, body weight, cardiovascular safety, renoprotection and
reduction of blood glucose levels is stated. Through a comparative analysis and presentation of
the collected scientific papers, which were used in this research, the paper questions the need
for additional research on GLP-1 agonists. This is an overview, theoretical paper, and it deals
with the drugs used in the treatment of type 2 diabetes, one of the most prevalent diseases in
the world. A systematic search of the literature according to the topic and subject of the
research, authors and journal is used for the preparation of the paper. Literature search is carried
out through online databases: PubMed, UpToDate, Cochrane and Elsevier. Expert articles,
guidelines, manuals and data from official websites relevant to the research topic will also be
used. Keywords for searching databases include the following terms: GLP-1 agonist, type 2
diabetes, clinical, effect, cardiovascular, importance, glucose. In the literature, the possible
mechanisms of action of GLP-1 agonists on lowering blood glucose and the physicochemical
properties of GLP-1 agonists, which make these drugs of great importance for clinical practice,
have been identified. The types of GLP-1 agonists, their chemical composition, doses,
properties and effects important for clinical practice in the treatment of type 2 diabetes are
studied with a critical review.
The effects of GLP-1 agonists on the human body are a consequence of their mechanism of
action in which there is an interaction with the GLP-1 receptor, which leads to an increase in
the concentration of intracellular cyclic adenosine monophosphate. Secretion of insulin is
dependent on glucose, and in case of elevated blood glucose concentration, insulin is secreted
from the β cells of pancreatic islets of Langerhans. GLP-1 agonists reduce glucagon secretion.
They also act by slowing down the stomach, which reduces the absorption of glucose from food
after a meal. The presented scientifically proven facts show that GLP-1 agonists are more
effective than some other antihyperglycemic drugs in reducing body weight, normalizing
glycemia, and protecting the cardiovascular system, kidney system, and other tissues in the
body. With a structured review, this paper enables quick finding of facts that are important for:
patients with type 2 diabetes, science, profession and clinical practice. |
