Tuesday, March 13, 2012

An Update on Emerging Therapies for the Practical Management of Diabetes

Eleuterio Ferrannini, MD; Dr. Diamant; Dr. Barnett; Dr. Davies, PhD; Dr. Hanefeld, PhD
CME Released: 10/24/2011; Valid for credit through 10/24/2012




Despite the availability of multiple pharmacologic agents, the treatment of patients with type 2 diabetes mellitus remains suboptimal. Given the disease's high and increasing prevalence, the morbidity, mortality, and economic consequences of type 2 diabetes are a great burden to patients, healthcare systems, and society.




Newer incretin-based agents for the treatment of type 2 diabetes include the glucagon-like peptide-1 (GLP-1) agonists, such as exenatide (now also available as a once-weekly injection) and liraglutide, as well as the dipeptidyl peptidase-4 (DPP-4) inhibitors, such as sitagliptin, saxagliptin, and the recently approved linagliptin, which can be used as a single dose even in patients with moderate to severe renal impairment.

Both classes have important clinical advantages in terms of weight control, reduced risk for hypoglycemias, and their effects on the insulin-secreting beta cells.

The latest emerging class is the SGLT2 inhibitors, which suppress glucose reabsorption in the kidney, thereby leading to the excretion of glucose in the urine. Once approved, they will be the only orally available antidiabetic drugs to trigger body weight reduction. They are also unique in that their glucose-lowering mechanism is completely insulin independent.

Together, these new classes have greatly expanded the choices for clinicians to help patients with type 2 diabetes achieve tighter glycemic control and better outcomes today and in the future.


Source : http://www.medscape.org/viewarticle/751705




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