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Recent advances in the treatment of type II diabetes mellitus
1Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, USA.
Abstract:
Diabetes mellitus needs to be managed early to prevent the onset and progression of complications. Diet and exercise may not be sufficient to achieve and maintain good glycemic control. Currently, no pharmacologic agent addresses all of the fundamental abnormalities in the pathogenesis of type II diabetes mellitus. However, the newer agents do not exacerbate the hyperinsulinemia that often occurs with type II diabetes, and they may help reduce the risk of cardiovascular disease that is associated with high insulin levels. Two of these agents, metformin and acarbose, have recently become available in the United States for the treatment of type II diabetes. With the availability of agents that differ in their mechanisms of action and side effect profiles, regimens can be individualized to address the variety of pathophysiologic abnormalities in type II diabetes. For this purpose, agents can be used alone or in combination.
Insights
Effective management of type 2 diabetes mellitus is crucial for preventing complications. Newer pharmacologic agents like metformin and acarbose offer individualized treatment options for better glycemic control and reduced cardiovascular risk.
Area of Science:
- Endocrinology
- Pharmacology
- Metabolic Diseases
Background:
- Type 2 diabetes mellitus (T2DM) management requires addressing fundamental pathophysiologic abnormalities.
- Diet and exercise alone are often insufficient for achieving optimal glycemic control in T2DM.
- Existing pharmacologic agents may exacerbate hyperinsulinemia, a common issue in T2DM.
Purpose of the Study:
- To review newer pharmacologic agents for T2DM treatment.
- To highlight agents that do not worsen hyperinsulinemia.
- To discuss the potential cardiovascular benefits of these newer agents.
Main Methods:
- Review of current literature on T2DM pharmacotherapy.
- Analysis of mechanisms of action for metformin and acarbose.
- Evaluation of side effect profiles and potential for combination therapy.
Main Results:
- Metformin and acarbose are newly available in the US for T2DM treatment.
- These agents do not exacerbate hyperinsulinemia and may reduce cardiovascular risk.
- Individualized treatment regimens can be developed using agents with different mechanisms and side effect profiles.
Conclusions:
- Newer agents like metformin and acarbose provide options for individualized T2DM management.
- Combination therapy with these agents can address multiple pathophysiologic defects in T2DM.
- These pharmacologic options may improve glycemic control and mitigate cardiovascular risks associated with T2DM.