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Postgrad Med J 84:524-531 doi:10.1136/pgmj.2008.067918
  • Review

Recent advances in the management of type 2 diabetes mellitus: a review

  1. B T Srinivasan1,2,
  2. J Jarvis1,
  3. K Khunti3,
  4. M J Davies2
  1. 1
    Department of Diabetes Research, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2
    Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
  3. 3
    Department of Health Sciences, University of Leicester, Leicester, UK
  1. J Jarvis, Diabetes Research, Level 1, Victoria Building, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK; janet.jarvis{at}uhl-tr.nhs.uk
  • Received 8 May 2008
  • Accepted 12 August 2008

Abstract

Type 2 diabetes mellitus (T2DM) is a progressive disorder caused by a combination of insulin resistance and β cell dysfunction. It is associated with an increased and premature risk of cardiovascular disease as well as specific microvascular complications such as retinopathy, nephropathy and neuropathy. In the last 5 years new glucose lowering drugs acting on novel pathways have been developed, licensed and launched, such as the glucagon-like peptide (GLP-1) agonists (exenatide) and dipeptidyl peptidase (DPP-IV) inhibitors such as sitagliptin and vildagliptin. This review looks at these new agents in terms of their mode of action, pharmacokinetics and use in clinical practice. This review also includes new agents in the area of weight loss that may have a positive effect for glucose management—for example, rimonabant.

Footnotes

  • Competing interests: BTS is a named candidate on an investigator initiated study funded by Sanofi-Aventis and has accepted grants to attend conferences from GSK. MJD has received funds for research, honoraria for speaking at meetings and has served on Advisory Boards for Lily, Sanofi Aventis, MSD and Novo Nordisk. KK has received funds for research, honoraria for speaking at meetings and served on advisory boards for Astra Zeneca, GSK, Lily, Novartis, Pfizer, Servier, Sanofi Aventis, MSD and Novo Nordisk. JJ has no competing interests.

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