Barlow-Walden LR, Reiter RJ, Abe M, Pablos M, Menendez-Pelaez A, Chen LD, et al
Lancet 379 , 815822 (2012)
A small trial including 8 patients with T1D showed improved postprandial hyperglycemia despite 20% insulin dose reduction ( 5 Cardiovascular and renal outcomes with GLP-1RA in T1D In patients with T2D, large RCT studies have shown that GLP-1RA treatment reduces the risk of cardiovascular and renal outcomes ( 6 Practical issues when prescribing GLP-1RA in T1D GLP-1RA are not currently approved for treatment of T1D, but they may still be covered by insurance if prescribed to treat obesity in these patients (although insurance coverage for obesity remains limited)
In addition to acting through the p38 pathway, GLP-1RAs also promote the increase of PKA levels via the cAMP-dependent pathway, which in turn prevents the phosphorylation of epidermal growth factor receptor (EGFR) and activator of transcription 3 (STAT3), resulting in the inactivation of the EGFR-STAT3 signaling pathway in tumor cells and subsequently downregulating several downstream effector genes such as myelocytomatosis oncogene (c-Myc), survivin, cyclin D1, Bcl-xl, and Bcl-2, thereby inducing apoptosis in tumor cells in a dose-dependent manner [70, 73]
