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There is a strong established relationship between diabetes and cardiovascular disease. Much of the latest research studies have identified a link between the inflammatory processes and the pathogenesis of both cardiovascular disease and diabetes. Specific inflammatory markers include: Interleukins 1,6,18; C-reactive protein, Fibrinogen, Tumor Necrosis Factor-α, PAI-I and cell adhesion molecules. As a result, there has been an emphasis on identifying therapeutic approaches that would improve both markers of inflammation and glucose control. The endocrine hormones known as incretins, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropicpolypeptide (GIP), are produced in the gastrointestinal tract following ingestion of a meal. In individuals with type 2 diabetes, endothelial dysfunction associated with premature atherosclerosis has been well documented. The purpose of this paper is to determine whether increasing levels of GLP-1 reduce markers of inflammation while improving both glucose control and cardiovascular risk factors. The review of literature explored the impact of increasing GLP-1, either though DPP-IV inhibitors or GLP-1 analogues, on various inflammatory markers in patients with type 2 diabetes. The studies reviewed provided ample support for the use of DPP-IV inhibitors to improve both glycemic control and cardiovascular risk factors. GLP-1 analogues also appear to have a similar impact, but with the added benefit of weight loss. In addition, patients with type 2 diabetes frequently have coagulation abnormalities leading to a prothromboticstate. Thus the reduction in fibrinogen, C-reactive protein and plasminogen activator inhibitor observed during the review of literature supports the potential for DPP-IV inhibitors and GLP-1 agonists to exhibits an antithrombotic effect. These findings are of clinical significance as these treatments may potentially slow the progression of premature cardiovascular disease as well as reduce thrombotic events in patients with type 2 diabetes.


Physician Assistant Studies

Degree Name

Master of Physician Assistant Studies (MPAS)

First Advisor

Terri Wold

Second Advisor

Susan Kuntz

Publication Date



Biomarkers; Blood Glucose -- drug effects: Cardiovascular Diseases -- drug therapy; Diabetes Mellitus, Type 2 -- drug therapy; Glucagon-Like Peptide 1; Hypoglycemic Agents; Inflammation -- drug therapy; Risk Factors


Cardiovascular Diseases | Endocrinology, Diabetes, and Metabolism

Impact of Increasing GLP-1 on Markers of Inflammation, Glucose Control and Cardiovascular Risk Factors in Patients With Type 2 Diabetes