Emerging Therapies for Type 2 Diabetes

Anthony   H.   Stonehouse; David   G.   Maggs

Abstract

Type 2 diabetes results from progressive β-cell dysfunction and insulin resistance, leading to progressive worsening of glycemic control, and increased risk of microvascular and macrovascular complications. Traditionally, treatment strategies for type 2 diabetes have concentrated on compensating for insulin deficiency and reducing insulin resistance. These approaches sequentially utilize diet and exercise, oral antidiabetic drug therapy, and ultimately, exogenous insulin. However, current therapies have little effect on the inexorable decline of β-cell dysfunction, and in a group of patients already overweight or obese, treatment often comes with further weight gain. Consequently, patients often experience deterioration of glycemic control as their disease progresses while battling obesity. Several new therapies including new insulin platforms and new classes of pharmaceutical agents with unique modes of action have recently been introduced or are in clinical development for use in patients with type 2 diabetes. These include amylinomimetics, incretin mimetics, DPP-IV inhibitors, and glucagon antagonists. These new agents improve glycemia and in some instances can reduce body weight. Furthermore, anti-obesity agents, either currently available or in development, are being investigated for their potential to treat diabetes. This review focuses primarily on these new therapeutic approaches, particularly those that improve glycemic control while improving control of body weight.

Keywords: Amylinomimetic, DPP-IV inhibitor, glucagon antagonist, incretin mimetic, rimonabant, weight lowering therapies

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