Pharmacotherapy of type 2 diabetes mellitus

Marc S. Rendell, William R. Kirchain

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

OBJECTIVE: To review the drug treatments and some of the popular, nontraditional remedies now available for type 2 diabetes mellitus, as well as selected investigational agents; to describe each medication's place in the overall approach to treatment. DATA SOURCES: English-language journals, abstracts, review articles, and newspaper accounts. DATA SYNTHESIS: In the past five years, there has been tremendous progress in the pharmacotherapy of diabetes, particularly type 2 diabetes. Several new agents have entered the clinical arena, and many more are in the late stages of investigation leading to approval. Sulfonylureas stimulate the production and release of insulin; these drugs must be used in patients with an intact pancreas. The meglitinides are nonsulfonylurea agents that are also insulin secretagogues. Unlike the sulfonylureas, repaglinide appears to require the presence of glucose to close the adenosine triphosphate-sensitive potassium channels and induce calcium influx. Metformin reduces hepatic glucose production in some patients and increases peripheral glucose utilization, but its use is hampered by a high percentage of adverse reactions. Disaccharidase inhibitors effectively compensate for the defective early-phase insulin release by slowing the production of sugars from carbohydrates. Thiazolidinediones appear to activate peroxisome proliferator-activated receptor gamma, which is involved in the metabolism of lipids. Short-acting insulin and the role of weight-loss agents are also discussed. CONCLUSIONS: The availability of new options for diabetes therapy provides a chance for successful therapy in a larger number of patients. However, it is important to consider how much true benefit these new forms of treatment will have on the diabetic community. The best choice for a patient remains controversial.

Original languageEnglish
Pages (from-to)878-895
Number of pages18
JournalAnnals of Pharmacotherapy
Volume34
Issue number7-8
StatePublished - 2000
Externally publishedYes

Fingerprint

Type 2 Diabetes Mellitus
Drug Therapy
repaglinide
Insulin
Glucose
Short-Acting Insulin
Anti-Obesity Agents
Disaccharidases
Therapeutics
Thiazolidinediones
Newspapers
PPAR gamma
Metformin
Potassium Channels
Lipid Metabolism
Pharmaceutical Preparations
Pancreas
Language
Adenosine Triphosphate
Carbohydrates

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Rendell, M. S., & Kirchain, W. R. (2000). Pharmacotherapy of type 2 diabetes mellitus. Annals of Pharmacotherapy, 34(7-8), 878-895.

Pharmacotherapy of type 2 diabetes mellitus. / Rendell, Marc S.; Kirchain, William R.

In: Annals of Pharmacotherapy, Vol. 34, No. 7-8, 2000, p. 878-895.

Research output: Contribution to journalReview article

Rendell, MS & Kirchain, WR 2000, 'Pharmacotherapy of type 2 diabetes mellitus', Annals of Pharmacotherapy, vol. 34, no. 7-8, pp. 878-895.
Rendell MS, Kirchain WR. Pharmacotherapy of type 2 diabetes mellitus. Annals of Pharmacotherapy. 2000;34(7-8):878-895.
Rendell, Marc S. ; Kirchain, William R. / Pharmacotherapy of type 2 diabetes mellitus. In: Annals of Pharmacotherapy. 2000 ; Vol. 34, No. 7-8. pp. 878-895.
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