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Investigational anti-hyperglycemic agents: the future of type 2 diabetes therapy?
Sachin K Majumdar1, Silvio E Inzucchi
1Section of Endocrinology, Department of Medicine, Bridgeport Hospital, Yale New Haven Health, 267 Grant Street, Bridgeport, CT 06610-0120, USA. psmaju@bpthosp.org
Abstract:
As the pandemic of type 2 diabetes spreads globally, clinicians face many challenges in treating an increasingly diverse patient population varying in age, comorbidities, and socioeconomic status. Current therapies for type 2 diabetes are often unable to alter the natural course of the disease and provide durable glycemic control, and side effects in the context of individual patient characteristics often limit treatment choices. This often results in the progression to insulin use and complex regimens that are difficult to maintain. Therefore, a number of agents are being developed to better address the pathogenesis of type 2 diabetes and to overcome limitations of current therapies. The hope is to provide more options for glucose lowering and complication reduction with less risk for hypoglycemia and other adverse effects. These agents include newer incretin-based therapies and PPAR agonists, as well as new therapeutic classes such as sodium-coupled glucose cotransporter 2 inhibitors, free fatty acid receptor agonists, 11-β-hydroxysteroid dehydrogenase type 1 inhibitors, glucokinase activators, and several others that may enter clinical use over the next decade. Herein we review these agents that are advancing through clinical trials and describe the rationale behind their use, mechanisms of action, and potential for glucose lowering, as well as what is known of their limitations.
Insights
New type 2 diabetes treatments are emerging to improve glycemic control and reduce complications. These novel agents aim for better efficacy and safety compared to current therapies for type 2 diabetes management.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Type 2 diabetes is a growing global health concern with diverse patient needs.
- Current treatments often fail to provide lasting glycemic control and have limitations due to side effects and patient-specific factors.
- Disease progression frequently leads to insulin dependence and complex treatment regimens.
Purpose of the Study:
- To review emerging therapeutic agents for type 2 diabetes.
- To evaluate novel treatments addressing disease pathogenesis and current therapy limitations.
- To provide an overview of agents in clinical trials, their mechanisms, efficacy, and safety profiles.
Main Methods:
- Review of current literature on type 2 diabetes pharmacotherapies.
- Analysis of agents in clinical development for type 2 diabetes.
- Examination of mechanisms of action, glucose-lowering potential, and adverse effects.
Main Results:
- Several new drug classes show promise for type 2 diabetes treatment.
- Emerging therapies include incretin-based agents, PPAR agonists, SGLT2 inhibitors, and others.
- These agents offer potential for improved glucose lowering and complication reduction with fewer side effects.
Conclusions:
- Novel therapeutic agents are advancing in clinical trials for type 2 diabetes.
- These new treatments aim to overcome limitations of existing therapies.
- Future options may provide more effective and safer glucose management for diverse patient populations.
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