[Type 2 diabetes mellitus: new treatments].
The benefits and problems associated with traditional hypoglycemic drugs, such as failure of beta cells, hypoglycemia and weight gain, that lead to a worsening of diabetes, are reviewed. New hypoglycemic drugs with incretin effect (glucagon-like peptide-1 agonists and dipeptidyl peptidase 4 inhibitors), achieve, in a glucose dependent manner, an glycosylated hemoglobin reduction without hypoglycemia or increase in body weight. Recently, another group of oral hypoglycemic drugs, sodium-glucose cotransporter type 2 inhibitors, have demonstrated efficacy in diabetes control by inhibiting renal glucose reabsorption. However, long-term effects and cardiovascular prevention remain to be demonstrated. We have more and better drugs nowadays. Hypoglycemic treatment should be customized (glycosylated hemoglobin levels, risk-benefit, risk of hypoglycemia, weight changes, cardiovascular risk), with a combination of drugs being necessary in most cases. However, we do not have yet an ideal hypoglycemic drug. Moreover we must remember that an early and intensive treatment of dyslipidemia and hypertension is essential for the prevention of cardiovascular disease in patients with type 2 diabetes.
Hospital Clínico Universitario de Valencia-INCLIVA, Departamento de Medicina, Universitat de València, Valencia, España; Centro de Investigación Biológica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Valencia, España. Electronic address: ascaso@uv.es.
Juan F
JF
Ascaso
D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D052216:Glucagon-Like Peptide 1 / Q000031:analogs & derivatives; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors
D007004:Hypoglycemic Agents; C089180:SLC5A2 protein, human; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D052216:Glucagon-Like Peptide 1
Análogos del péptido similar al glucagón tipo 1; Dipeptidyl peptidase 4 inhibitors; Glucagon-like peptide-1 agonists; Inhibidores de dipeptidil peptidasa 4; Inhibidores del cotransportador sodio-glucosa tipo 2; New hypoglycemic drugs; Nuevos hipoglucemiantes; Sodium-glucose cotransporter type 2 inhibitors