What are incretins, and how will they influence the management of type 2 diabetes?
OBJECTIVE
To review the pathophysiology of type 2 diabetes (T2DM), the role of incretins, the potential of incretin-based therapies to address unmet therapeutic needs in T2DM, and the potential impact this will have on the contribution of managed care pharmacy to diabetes therapy.


CONCLUSIONS
Diabetes, the fifth leading cause of death by disease in the United States, costs approximately $132 billion per year in direct and indirect medical expenses. According to the Centers for Disease Control and Prevention.s National Health and Nutrition Examination Survey, a majority of diabetes patients do not achieve target A1C levels with their current treatment regimens. Advances in understanding the pathophysiologic abnormalities underlying the metabolic dysfunctions associated with T2DM are leading to the development of new treatment approaches and new therapeutic classes of drugs. Novel incretin-based therapies currently available, and in late-stage development, are among those showing the greatest promise for addressing the unmet needs of traditional therapies.
Blonde
Lawrence
L
Ochsner Diabeed Clinical Research Unit, Department of Internal Medicine, Ochsner Clinic Foundation, 1514 Jefferson Hwy., New Orleans, LA 70121, USA. lblonde@ochsner.org
Rosenstock
Julio
J
Triplitt
Curtis
C
D000243:Adenosine Deaminase / Q000502:physiology; D058892:Adenosine Deaminase Inhibitors; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D018819:Dipeptidyl Peptidase 4 / Q000502:physiology; D054873:Dipeptidyl-Peptidase IV Inhibitors; D019468:Disease Management; D015195:Drug Design; D015507:Drugs, Investigational / Q000494:pharmacology; D052216:Glucagon-Like Peptide 1 / Q000819:agonists* / Q000031:analogs & derivatives* / Q000502:physiology; D006442:Glycated Hemoglobin; D006023:Glycoproteins / Q000037:antagonists & inhibitors* / Q000502:physiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007333:Insulin Resistance; D008329:Managed Care Programs; D009765:Obesity; D015995:Prevalence
D000243:Adenosine Deaminase; D058892:Adenosine Deaminase Inhibitors; D018819:Dipeptidyl Peptidase 4; D054873:Dipeptidyl-Peptidase IV Inhibitors; D015507:Drugs, Investigational; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D006023:Glycoproteins; D007004:Hypoglycemic Agents; C042807:DPP4 protein, human