< International Circulation>: The increased risk of cardiovascular disease in pre-diabetic patients is attributed to a multitude of factors. These include: insulin resistance, hyperglycaemia, dyslipidemia and hypertension. What progress has there been in the use of different pharmacological agents in patients with pre-diabetes?
< International Circulation>: Where is the research directive heading in AT1 receptor-dependent pathways and its mechanisms of anti-diabetic effects?
《国际循环》:这类药物针对AT1受体依赖途径和抗糖尿病机制方面的研究有哪些?
Prof Thomas Unger: If you are talking about anti-diabetic effects you in a way want to improve the action of insulin. One of the ways is of course to increase insulin concentrations and to get the pancreatic cells to release more insulin but this is limited. There are drugs available which can do that for diabetes treatment but limited in terms where at one point that when the drugs’ action is finished and the pancreatic cells can no longer increase their output of insulin. If you lower it then problems may arise and the patient may go into insulin dependency. Consequently, we have to treat them with insulin which has been done for many years in humans. But now we are thinking of improving the action of insulin . We are not increasing its concentrations or levels but at its action on the receptor site or at the signalling pathway of insulin. Now if you look at the insulin signalling pathway as to how insulin gets glucose to the cells there are several steps where angiotensin interacts via the AT-1 receptor in a negative way. So, if you block the AT-1 receptor then you can actually take away this negative effect of angiotensin on the