New therapeutic agents for diabetes mellitus: implications for anesthetic management.
Multiple hormones and transmitter systems contribute to glucose homeostasis and the control of metabolism. Recently, the gastrointestinal peptide hormones glucagon-like peptide 1 and amylin have been shown to significantly contribute to this complex physiology. These advances provide the foundation for new treatments for diabetes mellitus. Therapies based on glucagon-like peptide 1 and amylin have now been introduced into clinical practice. Rimonabant, the selective endocannabinoid receptor antagonist, had been used in European countries for the treatment of obesity; it has recently been withdrawn for this indication. This drug exhibited therapeutic benefits for metabolic variables and for type 2 diabetes mellitus. Anesthesia providers caring for patients with diabetes mellitus will need to understand the implications of these new therapies in perioperative settings, particularly with respect to side effects and interactions.
Chen
Daniel
D
Department of Anesthesiology, Hospital for Special Surgery, New York, New York, USA.
Lee
Stephanie L
SL
Peterfreund
Robert A
RA
D000682:Amyloid / Q000627:therapeutic use; D000758:Anesthesia; D000818:Animals; D063385:Cannabinoid Receptor Modulators / Q000502:physiology; D003920:Diabetes Mellitus / Q000188:drug therapy*; D052216:Glucagon-Like Peptide 1 / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D054795:Incretins / Q000502:physiology; D058228:Islet Amyloid Polypeptide
D000682:Amyloid; D063385:Cannabinoid Receptor Modulators; D007004:Hypoglycemic Agents; D054795:Incretins; D058228:Islet Amyloid Polypeptide; D052216:Glucagon-Like Peptide 1