[New oral antidiabetic agents--clinical perspectives].
In recent years new pharmacological agents have emerged, which enable us to widen the spectrum of diabetes management based on clear pathophysiological concepts. One should first of all mention the DPP4-inhibitors and the incretin mimetics, which have the potential of restoring the incretin effect in patients with type 2 diabetes mellitus. Moreover, it has been shown that the agent rimonabant, which was first used in order to achieve weight reduction, also contributed to the significant improvement of metabolic syndrome's parameters. Recent studies have shown that the dual alpha/gamma-PPAR-agonists have serious adverse effects. The thiazolidinediones (glitazones) significantly improve insulin sensitivity, diminish fat accumulation in the liver and increase circulating levels of adiponectin. Various adverse effects of glitazones have been described in recent studies. In the near future one should await the discovery of more oral antidiabetic agents acting through modulation of important enzymes in glucose metabolism and transport pathways.
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Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany. sabine.fischer@uniklinikum-dresden.de
Bornstein
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D016907:Adverse Drug Reaction Reporting Systems; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D018819:Dipeptidyl Peptidase 4; D054873:Dipeptidyl-Peptidase IV Inhibitors; D005260:Female; D005598:Fractures, Spontaneous / Q000139:chemically induced; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D054795:Incretins / Q000031:analogs & derivatives / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000188:drug therapy; D047493:PPAR alpha / Q000819:agonists; D047495:PPAR gamma / Q000819:agonists; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D045162:Thiazolidinediones / Q000009:adverse effects / Q000627:therapeutic use
D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D054795:Incretins; D047493:PPAR alpha; D047495:PPAR gamma; C089180:SLC5A2 protein, human; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D045162:Thiazolidinediones; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4