Type 2 diabetes mellitus (T2DM) is
increasing in global prevalence
and is associated with serious health problems (e.g., cardiovascular
disease). Various treatment options are available for T2DM, including
the incretin hormone glucagon-like peptide-1 (GLP-1). GLP-1 is a therapeutic
peptide secreted from the intestines following food intake, which
stimulates the secretion of insulin from the pancreas. The native
GLP-1 has a very short plasma half-life, owning to renal clearance
and degradation by the enzyme dipeptidyl peptidase-4. To overcome
this issue, various GLP-1 agonists with increased resistance to proteolytic
degradation and reduced renal clearance have been developed, with
several currently marketed. Strategies, such as controlled release
delivery systems, methods to reduce renal clearance (e.g., PEGylation
and conjugation to antibodies), and methods to improve proteolytic
stability (e.g., stapling, cyclization, and glycosylation) provide
means to further improve the ability of GLP-1 analogs. These will
be discussed in this literature review.