Pharmacotherapy of hyperglycemia

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic, progressive disorder that affects more than 230 million people worldwide and is expected to affect 366 million by 2030. Both the prevalence of T2DM and the cost of its long term complications has driven the focus and emphasis on treatments aimed at reducing hyperglycemia and controlling hypertension and dyslipidemia. In the last 5 years new glucose lowering drugs acting on novel pathways have been developed, licensed and launched. These drugs include the glucagon-like peptide (GLP-1) agonists, exenatide, and dipeptidyl peptidase (DPP-IV) inhibitors such as sitagliptin and saxagliptin. This review describes current approaches to T2DM treatment, focusing on newer agents which tend to be associated with less hypoglycemia and possible weight loss, and addresses the potential roles of novel oral pharmacologic agents in the late-stages of development that might provide new options for the management of this disease.