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A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
Published on: February 28, 2013
Evolving treatment strategies for the management of type 2 diabetes
1Joint Program on Diabetes, Endocrinology and Metabolism, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA. william.cefalu@pbrc.edu
Abstract:
It is well known that improved metabolic control significantly reduces both micro- and macrovascular complications in diabetes. As it relates to specific treatment of type 2 diabetes mellitus, clinicians have traditionally initiated lifestyle intervention and progressed therapy using various drug treatments first as monotherapy and then as combination therapy throughout the course of the disease. This "stepwise" strategy has not always achieved the desired outcome of normal glycemic control; consequently, several clinical problems, such as hypoglycemia, weight gain and postprandial hyperglycemia, persist. However, new therapies that improve glycemic control and have favorable effects to address the unmet clinical problems have recently been developed or are still in development. These therapies include 2 classes of incretin-directed therapy, the dipeptidyl peptidase-4 inhibitors and the glucagon-like peptide-1 agonists, which help restore physiologic levels and activity of the incretin glucagon-like peptide-1. Also in development are additional therapies that have effects on the kidney to promote glucose excretion. These therapies are proposed to treat the key metabolic abnormalities associated with type 2 diabetes mellitus and minimize the side effects noted with conventional therapies.
Insights
New therapies for type 2 diabetes mellitus, including incretin-directed treatments and kidney-acting drugs, offer improved glycemic control. These advancements aim to address persistent clinical issues like hypoglycemia and weight gain associated with traditional stepwise approaches.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Improved metabolic control is crucial for reducing diabetes complications.
- Traditional stepwise treatment for type 2 diabetes mellitus often fails to achieve optimal glycemic control.
- Conventional therapies can lead to persistent issues such as hypoglycemia, weight gain, and postprandial hyperglycemia.
Purpose of the Study:
- To review emerging therapies for type 2 diabetes mellitus.
- To highlight treatments addressing unmet clinical needs and side effects of conventional therapies.
- To discuss incretin-directed therapies and agents affecting renal glucose excretion.
Main Methods:
- Review of current literature on diabetes treatment strategies.
- Analysis of novel therapeutic classes including dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 agonists.
- Examination of investigational therapies targeting kidney glucose excretion.
Main Results:
- New therapies demonstrate potential for improved glycemic control.
- Incretin-based therapies restore physiological incretin activity.
- Emerging treatments may offer favorable side effect profiles compared to conventional drugs.
Conclusions:
- Novel therapeutic strategies are being developed to enhance glycemic control in type 2 diabetes.
- Incretin-directed therapies and agents promoting glucose excretion represent promising advancements.
- These new approaches aim to overcome limitations of traditional stepwise treatment and minimize adverse effects.
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