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Review
. 2024 Mar;40(3):212-220.
doi: 10.1002/kjm2.12800. Epub 2024 Jan 6.

Recent advances in the treatment of type 2 diabetes mellitus using new drug therapies

Keong Chong  1   2 , Jack Keng-Jui Chang  3 , Lee-Ming Chuang  4
Affiliations
Review

Recent advances in the treatment of type 2 diabetes mellitus using new drug therapies

Keong Chong et al. Kaohsiung J Med Sci. 2024 Mar.

Abstract

Several recent advances provide multiple health benefits to individuals with type 2 diabetes mellitus (T2DM). Pharmacological therapy is governed by person-centered factors, including comorbidities and treatment goals. Adults with T2DM who have an established/high risk of atherosclerotic cardiovascular disease, heart failure, and/or chronic kidney disease, require a treatment regimen that includes agents that are proven to reduce cardiorenal risk. Weight management plays a key role in reducing glucose for patients with T2DM. A glucose-reduction treatment regimen must consider weight management. Sodium glucose co-transporter 2 (SGLT2) inhibitors reduce the risk of heart failure, cardiovascular and renal events. Glucagon-like peptide-1 (GLP-1) receptor agonists allow better control of glycemia, promote weight loss and reduce the risk of cardiovascular events. Newer Glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 dual agonist, which activate GIP and GLP-1 receptors improve glycemic control and promote greater weight loss than GLP-1 receptor agonists. Several novel drugs are in the clinical development phase. This review pertains to recent advances in pharmacological management of type 2 diabetes.

Keywords: glucagon-like peptide-1 (GLP-1) receptor agonists; insulin icodec; retatrutide; sodium glucose co-transporters 2 (SGLT2) inhibitors; tirzepatide.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Changes in T2DM treatment algorithms (graph is modified from ref. and ref. 3 ). ASCVD, Atherosclerotic cardiovascular disease; CKD, chronic kidney disease; CV, cardiovascular; DPP4i, dipeptidyl peptidase‐4 inhibitor; DSMES, diabetes self‐management and education support; GLP‐1 RA, Glucagon‐like peptide‐1 receptor agonist; HF, heart failure; SGLT2i, sodium‐glucose cotransport 2 inhibitor; SDOH, social determinants of health; SU, sulphonylurea; TZD, thiazolidinedione.
FIGURE 2
FIGURE 2
Summary of the metabolic effect and the landmark trials of SGLT‐2 inhibitors. BW, body weight; CV, cardiovascular; ESKD, end‐stage kidney disease; ESRD, end‐stage renal disease; HF, heart failure; MARE, major adverse renal event; 3P MACE, 3‐point major adverse cardiovascular event; SBP, systolic blood pressure.
FIGURE 3
FIGURE 3
Summary of the metabolic effect and the landmark trials of GLP‐1 receptor agonists. BW, body weight; SBP, systolic blood pressure; 3P MACE: 3‐point major adverse cardiovascular event.
See this image and copyright information in PMC

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