The use of insulin secretagogues in the treatment of type 2 diabetes.
Secretatogues are a class of agents that achieve their hypoglycemic effects through stimulating insulin release. They include the sulfonylureas, repaglinide, and the investigational agent glucagon-like peptide. The secretagogue agents have been studied extensively as monotherapy and in conjunction with other classes of oral agents, including alpha-glucosidase inhibitors, bijuanides, and thiazolidinediones, for the treatment of type 2 diabetes. This article reviews the pharmacodynamic and pharmacokinetic differences of the secretagogues, as well as the most recent clinical trials. Such information should be helpful when deciding which agent or agents will yield the best glycemic control for an individual patient.
Luna
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Department of Internal Medicine and Infectious Disease, Campbell University School of Pharmacy, Durham, North Carolina 27710, USA.
Hughes
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AT
Feinglos
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MN
D020909:Acarbose / Q000627:therapeutic use; D002219:Carbamates / Q000627:therapeutic use; D002839:Chromans / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005934:Glucagon / Q000627:therapeutic use; D052216:Glucagon-Like Peptide 1; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use; D010446:Peptide Fragments / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D011498:Protein Precursors / Q000627:therapeutic use; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D013844:Thiazoles / Q000627:therapeutic use; D045162:Thiazolidinediones; D000077288:Troglitazone
D002219:Carbamates; D002839:Chromans; D007004:Hypoglycemic Agents; D010446:Peptide Fragments; D010880:Piperidines; D011498:Protein Precursors; D013453:Sulfonylurea Compounds; D013844:Thiazoles; D045162:Thiazolidinediones; C072379:repaglinide; D052216:Glucagon-Like Peptide 1; D005934:Glucagon; D008687:Metformin; D000077288:Troglitazone; D020909:Acarbose