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Glucose Lowering Treatment Modalities of Type 2 Diabetes Mellitus

Asena Gökçay Canpolat1, Mustafa Şahin2

  • 1Department of Endocrinology and Metabolism, Ankara University School of Medicine, Ankara, Turkey.

Advances in Experimental Medicine and Biology
|March 23, 2020
PubMed

Insights

This review discusses antidiabetic drugs targeting the "Ominous Octet" of type 2 diabetes pathophysiology. Newer agents like GLP-1 RAs and SGLT-2 inhibitors are preferred for their broader benefits, shifting treatment paradigms.

Area of Science:

  • Endocrinology and Metabolism
  • Pharmacology

Background:

  • Type 2 diabetes involves eight key pathophysiological mechanisms, termed the "Ominous Octet."
  • Traditional antidiabetic agents like meglitinides and sulfonylureas primarily address glucose levels.

Purpose of the Study:

  • To provide an overview of current knowledge and clinical aspects of antidiabetic drugs.
  • To highlight the paradigm shift towards newer agents with additional organ-protective effects.

Main Methods:

  • Review of recent research evidence and clinical expertise on antidiabetic pharmacotherapy.
  • Analysis of agents targeting the "Ominous Octet" mechanisms.

Main Results:

  • A shift in treatment initiation from older agents to newer ones, including GLP-1 Receptor Agonists (RA) and SGLT-2 inhibitors.
  • Newer agents demonstrate beneficial effects on the kidney and heart, despite long-term safety concerns.

Conclusions:

  • Optimal antidiabetic agent selection requires patient-centered care, considering adherence, weight management, and comorbidities.
  • The evolving treatment landscape prioritizes agents with multifaceted benefits beyond glycemic control.
Keywords:
AcarboseDipeptidyl peptidase 4 inhibitorsGlucagon-like peptide 1 receptor agonistsGlucose-lowering therapiesMeglitinidesMetforminSodium-glucose transporter two inhibitorsSulphonylureaThiazolidinediones

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