Renal protection of exenatide in patients with early diabetes nephropathy

Diabetes nephropathy (DKD) is a glomerulosclerosis caused by metabolic disorder and hemodynamic changes caused by chronic hyperglycemia. It is one of the most common chronic microvascular complications in diabetes patients. The incidence rate of DKD increases year by year with the increase of diabetes incidence rate. After 10 years of diabetes onset, 40%~50% of patients have DKD, which is one of the important factors leading to end-stage renal failure and patient death.

At present, there is a lack of effective means to treat DKD. In clinical practice, the disease progress is mainly controlled by routine symptomatic programs such as controlling blood pressure, blood sugar, and reducing protein intake, but the improvement of proteinuria that has occurred is limited. Glucagon peptide-1 (GLP-1) is one of the hot spots in the treatment of diabetes in recent years. Exenatide is the first GLP-1 receptor agonist approved for clinical use. It reduces blood sugar in a glucose dependent manner. Single drug use rarely causes hypoglycemia, which can reduce the body mass of patients with type 2 diabetes and improve lipid metabolism and islet function. In addition to its hypoglycemic effect, GLP-1 also has the characteristics of multiple effects of one drug, such as anti oxidative stress, inhibition of apoptosis, and foreign studies have shown that it has a certain protective effect on diabetes kidney

Exenatide was originally isolated from the saliva of the Gila monitor lizard, which can activate the human GLP-1 receptor to play an anti hyperglycemic role similar to GLP-1. Exenatide impurities can not only control blood glucose, but also improve pancreatic islets β Cell function, stimulating islets of langerhans β Cell proliferation and differentiation