4.7 Review

Pharmacotherapy of type 2 diabetes: An update and future directions

Journal

METABOLISM-CLINICAL AND EXPERIMENTAL
Volume 137, Issue -, Pages -

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.metabol.2022.155332

Keywords

Diabetes mellitus; Pharmacotherapy; Biguanides; Sulfonylureas; Meglitinides; ?-Glucosidase inhibitors; Thiazolidinediones; Amylin analogs; Sodium-glucose cotransporter 2 inhibitors; Glucagon-like peptide-1 receptor agonists

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This review provides an updated summary of the pharmacotherapeutic approach to type 2 diabetes (T2D), including the mechanism of action, administration details, side effect profile, cost, and use in specific populations of different classes of agents. It also reviews the targets of novel therapeutic T2D agent development. Finally, it outlines a contemporary treatment approach starting with the identification of an individualized glycemic control goal, followed by the selection, initiation, and further intensification of a personalized therapeutic plan for T2D.
Type 2 diabetes (T2D) is a widely prevalent disease with substantial economic and social impact for which multiple conventional and novel pharmacotherapies are currently available; however, the landscape of T2D treatment is constantly changing as new therapies emerge and the understanding of currently available agents deepens. This review aims to provide an updated summary of the pharmacotherapeutic approach to T2D. Each class of agents is presented by mechanism of action, details of administration, side effect profile, cost, and use in certain populations including heart failure, non-alcoholic fatty liver disease, obesity, chronic kidney disease, and older individuals. We also review targets of novel therapeutic T2D agent development. Finally, we outline an up-to-date treatment approach that starts with identification of an individualized goal for glycemic control then selection, initiation, and further intensification of a personalized therapeutic plan for T2D.

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