Kerry-Anne Rye

ApoA-I—the main apolipoprotein constituent of the HDL (high-density lipoprotein) fraction of human plasma—is of therapeutic interest because it has several cardioprotective functions. Recent reports have established that apoA-I also has antidiabetic properties. In addition to improving glycemic control by increasing insulin sensitivity, apoA-I improves pancreatic β-cell function by amplifying expression of transcription factors that are essential for β-cell survival and increasing insulin production and secretion in response to a glucose challenge. These findings indicate that increasing circulating apoA-I levels may be of therapeutic value in patients with diabetes in whom management of glycemic control is suboptimal. This review summarizes current knowledge of the antidiabetic functions of apoA-I and the mechanistic basis of these effects. It also evaluates the therapeutic potential of small, clinically relevant peptides that mimic the antidiabetic functions of full-length apoA-I and describes potential strategies for development of these peptides into innovative options for treatment of diabetes.