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GLP-1 based therapies: clinical implications for gastroenterologists
  1. Mark M Smits1,
  2. Daniel H van Raalte1,
  3. Lennart Tonneijck1,
  4. Marcel H A Muskiet1,
  5. Mark H H Kramer1,
  6. Djuna L Cahen2
  1. 1Department of Internal Medicine, Diabetes Center, VU University Medical Center, Amsterdam, The Netherlands
  2. 2Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
  1. Correspondence to Dr Mark Smits, Department of Internal Medicine, Diabetes Center, VU University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands; mm.smits1{at}


The gut-derived incretin hormone, glucagon-like peptide 1 (GLP-1) lowers postprandial blood glucose levels by stimulating insulin and inhibiting glucagon secretion. Two novel antihyperglycaemic drug classes augment these effects; GLP-1 receptor agonists and inhibitors of the GLP-1 degrading enzyme dipeptidyl peptidase 4. These so called GLP-1 based or incretin based drugs are increasingly used to treat type 2 diabetes, because of a low risk of hypoglycaemia and favourable effect on body weight, blood pressure and lipid profiles. Besides glucose control, GLP-1 functions as an enterogastrone, causing a wide range of GI responses. Studies have shown that endogenous GLP-1 and its derived therapies slow down digestion by affecting the stomach, intestines, exocrine pancreas, gallbladder and liver. Understanding the GI actions of GLP-1 based therapies is clinically relevant; because GI side effects are common and need to be recognised, and because these drugs may be used to treat GI disease.


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