The postprandial actions of GLP-1 receptor agonists: The missing link for cardiovascular and kidney protection in type 2 diabetes

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Abstract

Recent clinical trials in people with type 2 diabetes have demonstrated beneficial actions on heart and kidney outcomes following treatment with GLP-1RAs. In part, these actions are consistent with improved glucose control and significant weight loss. But GLP-1RAs may also have additive benefits by improving postprandial dysmetabolism. In diabetes, dysregulated postprandial nutrient excursions trigger inflammation, oxidative stress, endothelial dysfunction, thrombogenicity, and endotoxemia; alter hormone levels; and modulate cardiac output and regional blood and lymphatic flow. In this perspective, we explore the actions of GLP-1RAs on the postprandial state and their potential role in end-organ benefits observed in recent trials.

Original languageEnglish
Pages (from-to)253-273
Number of pages21
JournalCell Metabolism
Volume35
Issue number2
DOIs
Publication statusPublished - 7 Feb 2023

Keywords

  • cardioprotection
  • cardiovascular outcomes
  • diabetic complications
  • GLP-1 receptor
  • GLP-1 receptor agonist
  • glucagon-like peptide-1
  • major acute cardiovascular event
  • renoprotection
  • type 2 diabetes

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