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The backbone of oral glucose‐lowering therapy: time for a paradigm shift?
Author(s) -
Seufert Jochen
Publication year - 2009
Publication title -
fundamental and clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.655
H-Index - 73
eISSN - 1472-8206
pISSN - 0767-3981
DOI - 10.1111/j.1472-8206.2009.00676.x
Subject(s) - glycemic , metformin , postprandial , medicine , dipeptidyl peptidase 4 , type 2 diabetes , diabetes mellitus , pharmacology , intervention (counseling) , endocrinology , psychiatry
Abstract The complex array of metabolic abnormalities associated with type 2 diabetes provides a number of new targets for therapeutic intervention. Although the established oral glucose‐lowering therapies, metformin and the sulfonylureas, continue to provide the backbone of therapeutic approaches, the thiazolidinediones (TZDs) also play an important role. Further, a new class of oral agents, the dipeptidyl peptidase‐IV (DPP‐IV) inhibitors, has recently become available with apparent utility in decreasing postprandial glucose excursions. This review examines how the TZDs and the DPP‐IV inhibitors might integrate into current treatment strategies, considering not only glycemic goals, but also longer‐term benefits such as durability of glycemic control, effect on metabolic parameters and cardiovascular outcomes. A practical approach is taken, reflecting potential clinical situations in which therapeutic intervention is required.