Newer therapeutic options for children with diabetes mellitus: Theoretical and practical considerations

George S. Jeha, Rubina A. Heptulla

Research output: Contribution to journalReview article

20 Scopus citations

Abstract

Recent studies in adult patients with type 1 diabetes mellitus (T1DM) and T2DM have examined the potential utility, benefits, and side effects of agents that augment insulin secretion after oral ingestion of nutrients in comparison with intravenous nutrient delivery, the so-called incretins. Two families of incretin-like substances are now approved for use in adults. Glucagon-like peptide-1 (GLP-1) or agents that bind to its receptor (exenatide, Byetta ®) or agents that inhibit its destruction [dipeptidy] peptidase-IV (DPP-IV) inhibitors, Vildagliptin] improve insulin secretion, delay gastric emptying, and suppress glucagon secretion while decreasing food intake without increasing hypoglycemia. Pramlintide, a synthetic amylin analog, also decreases glucagon secretion and delays astric emptying, improves hemoglobin A1c (HbA1C), and facilitates weight reduction without causing hypoglycemia. We review the historical discovery of these agents, their physiology applications, and their current applications. Remarkably, only one or two studies have been reported in children. Pediatricians caring for children with T1DM and T2DM should become familiar with these agents and investigate their applicability, as they seem likely to enhance our therapeutic armamentarium to treat children with diabetes mellitus.

Original languageEnglish (US)
Pages (from-to)122-138
Number of pages17
JournalPediatric Diabetes
Volume7
Issue number2
DOIs
StatePublished - May 1 2006

Keywords

  • Amylin
  • Dipeptidyl peptidase-IV
  • Exenatide
  • Exendin 4
  • Gastric emptying
  • Glucagon-like peptide-l
  • Hyperglycemia
  • Hypoglycemia
  • Incretins
  • Liraglutide
  • Pramlintide
  • Type 1 diabetes mellitus-type 2 diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism

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