Pharmacologic management of diabetes mellitus

Recently, the number of agents to treat type 2 diabetes has increased markedly. In the past, the only agents practitioners had available to treat patients with type 2 diabetes mellitus were insulin and sulfonylureas. Today, three additional classes of agents with a total of six new drugs are available: acarbose, migital, repaglinide, metformin hydrochloride, troglitazone, and rosiglitazone. In the not-too-distant future, several other agents will be available for treating patients with diabetes. These new agents will allow physicians to control their diabetic patients' blood sugar levels without the need for insulin injections. This article reviews the new agents and provides practical suggestions regarding their use as monotherapy or in combination therapy.