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Multidisciplinary Interventions

Mapping New Horizons in Diabetes Care

From Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts (Dr Horton), Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana (Dr Cefalu), University of Maryland School of Pharmacy, Baltimore, Maryland (Dr Haines), and the University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Siminerio).

Correspondence to Edward Horton, MD, Vice President and Director of Clinical Research, Joslin Diabetes Center, Harvard Medical School, One Joslin Place, Boston, MA 02215 (Edward.Horton{at}joslin.harvard.edu).

More than 20 million people in the United States, or 7% of the population, have diabetes, with health care and work-related costs estimated to be $174 billion in 2007. Obesity constitutes one of the major driving factors behind this epidemic.

Most drugs currently used to treat diabetes address the primary metabolic defects in type 2 diabetes mellitus, which are insulin resistance and pancreatic islet dysfunction. Incretin augmentation therapies, such as glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase IV inhibitors, restore glucose homeostasis by addressing some of the unmet needs in diabetes therapies related to -cell dysfunction and chronic β-cell dysfunction. This new group of drugs offers certain advantages because its use is characterized by a low incidence of hypoglycemia and the absence of weight gain. Moreover, the use of fixed-dose combinations of dipeptidyl peptidase IV inhibitors with other oral antidiabetic agents seems very attractive to patients because of their reduced pill intake and minimized financial burden, which may improve adherence.

An efficient strategy to slow down the epidemic of diabetes must include these emerging therapies and regimens, coupled with intensive patient education that includes information on treatment benefits and adverse effects, medication costs, and medication regimen complexity.

The Diabetes Educator, Vol. 34, No. Supplement 4, 78S-89S (2008)
DOI: 10.1177/0145721708321148


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