Update in the pharmacologic treatment of diabetes mellitus: focus on pramlintide and exenatide.
There are now more than 20 million people in America with diabetes mellitus (DM), and the prevalence of this illness continues to increase especially in those with type 2 DM. Over the past decade, research in the area of DM treatment has focused on pharmacologic approaches to modifying glucose metabolism as well as on lifestyle interventions to prevent and manage DM. Pharmacologic research has been guided by an improved understanding of the human physiology of glucose metabolism, allowing for development of new hormonal drug therapies and improved insulin formulations. As a result, there are several new pharmacologic treatments now available or on the horizon for DM. In this article, the authors review the first of the new hormonal therapies for DM, with a focus on information that will be useful for diabetes educators including the medication actions, side effects, patient counseling points, monitoring, and place in therapy in comparison to existing DM treatments. This series on new therapies has been divided into 3 parts, with this first part devoted to an update on the new incretin mimetic and amylin analog agents recently approved for use in DM. Subsequent parts in this series will focus on the new insulin products and oral therapies available or soon to be available. Cases will be used to assist with understanding the type of patient who will benefit from each of these new therapies.
Odegard
Peggy Soule
PS
The School of Pharmacy, University of Washington, Seattle, and Evergreen Senior Health Specialists, Kirkland, Washington (Dr Odegard)
Setter
Stephen M
SM
The College of Pharmacy, Washington State University, Spokane (Dr Setter, Dr Iltz)
Iltz
Jason L
JL
The College of Pharmacy, Washington State University, Spokane (Dr Setter, Dr Iltz)
D000682:Amyloid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D000075202:Contraindications; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000534:rehabilitation; D000077270:Exenatide; D005934:Glucagon / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D058228:Islet Amyloid Polypeptide; D010353:Patient Education as Topic; D010455:Peptides / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014688:Venoms / Q000493:pharmacokinetics / Q000627:therapeutic use*
D000682:Amyloid; D007004:Hypoglycemic Agents; D007328:Insulin; D058228:Islet Amyloid Polypeptide; D010455:Peptides; D014688:Venoms; D005934:Glucagon; D000077270:Exenatide; C105254:pramlintide