Expanding treatment options for type 2 diabetes: the old and the new.
OBJECTIVE
Type 2 diabetes is characterized by multiple metabolic abnormalities including the dysfunction of pancreatic islet cells. Current treatment options have different mechanisms of action and are variably effective at lowering blood glucose levels. The newest pharmacologic treatments, incretin mimetics and dipeptidyl peptidase-IV (DPP-4) inhibitors, target the incretin system, and it is important to understand their role in current treatment paradigms and in addressing the basic pathophysiology of type 2 diabetes-pancreatic islet cell dysfunction.


CONCLUSIONS
This article discusses the pathophysiology of type 2 diabetes including impairment of the incretin effect, and explains how incretin mimetics and DPP-4 inhibitors are being incorporated into treatment algorithms to address pancreatic islet cell dysfunction and enable patients to achieve glycemic targets.
Pratley
Richard E
RE
Department of Medicine, University of Vermont College of Medicine, Colchester Research Facility 110C, Colchester, Vermont 05446, USA.
D000465:Algorithms; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology*; D018819:Dipeptidyl Peptidase 4; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D054795:Incretins / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D011480:Protease Inhibitors / Q000627:therapeutic use*
D001786:Blood Glucose; D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D054795:Incretins; D007328:Insulin; D011480:Protease Inhibitors; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4