(GIP?, PACAP?, others?)

Restoration of lack of biphasic insulin secretion

Yes (Exanatide)

Not tested

Counterregulation by glucagon preserved in hypoglycemia


Not tested

Inhibition of gastric emptying



Effect on body weight

Weight loss

Weight neutral

Predominant adverse effects



Mode of administration



useful in slowing the progression of type 2 diabetes or to be used as anti-obesity agents due to their effects on body weight and beta-cell mass and function (88), but here lifestyle intervention and metformin are also effective (89). Incretin mimetics have the advantage of exclusively activating the GLP-1 receptor and therefore exerting exclusively the desired GLP-1-like effects (Table 1) in comparison to DPP-4 inhibitors. DPP-4 inhibitors have the benefit of being oral (and maybe less costly) agents, but their multiple effects besides raising endogenous GLP-1 concentrations are currently not completely elucidated (81). So far, only data from clinical trials covering a timeframe of 1 to 2 years are available. Long-term effects of GLP-1 analogs, incretin mimetics and DPP-4 inhibitors, e.g., on beta-cell proliferation and on the brain have to be followed in clinical practice (90).

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