New and Future Medications for the Treatment of Type 2 Diabetes Mellitus

Abstract

With almost 30 million individuals predicted to be diagnosed by the year 2025, type 2 diabetes mellitus (T2DM) has become one of the most prevalent diseases in the United States. Because of the progressive dysfunction of the pancreatic β-cells and increasing insulin resistance over time, the need for treatments with different mechanisms or addition of medications to a regimen is becoming commonplace. Because of this, developing new medications to treat T2DM has been the focus of a lot of recent research and drug development. Molecular substrates such as glucagonlike peptide-1 (GLP-1), dipeptidyl peptidase-4 (DPP-4), and the sodium glucose transporter-2 (SGLT2) have all become new therapeutic targets. GLP-1 agonists and DPP-4 inhibitors are 2 of the newest classes of Food and Drug Administration-approved medications for diabetes. By increasing GLP-1 to supraphysiologic levels (GLP-1 agonists) and delaying endogenous GLP-1 degradation (DPP-4 inhibitors), these drugs increase insulin secretion and decrease glucagon production. SGLT2 inhibitors, the newest antihyperglycemic class, promote glycosuria by inhibiting sodium and glucose reabsorption in the proximal tubule of the renal nephron.Other novel agents for the treatment of diabetes include the use of the dopamine agonist bromocriptine, the cholesterol medication colesevelam, and a new form of inhaled insulin.

Inhaled Insulin – A New Delivery for an Old Drug

“…Type 2 develops in adolescence or adulthood and is associated with insulin resistance and defi ciency, oft en as a result of a sedentary lifestyle, obesity and aging. Gestational diabetes mellitus develops during pregnancy as a result of hormonal insulin resistance (Bennett & Joseph, 2013;Mathers, Zarbock, & Sutton, 2014).…”

Canagliflozin: A novel SGLT2 inhibitor for type 2 diabetes mellitus

“…Therefore, the current focus of research is an anti-diabetic agent that can improve glycemic control without increasing hypoglycemia, can promote weight loss, improve β- cell function, while reducing complications and mortality associated with the disease and which is safe enough to be used in renal or hepatic compromise. [ 23 ]…”

“…Patients with high blood glucose levels usually experience glycosuria and nocturia, which has been used as a diagnostic feature for diabetes and indicates poor glycaemic control. [ 23 ] Actually, this glucose load excreted by the body is what is left after glucose has passed through the renal nephron. Glucosuria is now recognized as a feasible insulin-independent mechanism that reduces blood glucose without causing hypoglycemia and facilitating weight loss.…”