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The Diabetes Educator
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FEATURES

Expanding Treatment Options for Type 2 Diabetes

The Old and the New

Richard E. Pratley, MD

From the University of Vermont College of Medicine, Burlington, Vermont

Correspondence to Richard E. Pratley, MD, Professor of Medicine, University of Vermont College of Medicine, Department of Medicine, Colchester Research Facility 110C, 208 South Park Street, Colchester, VT 05446

Purpose

Type 2 diabetes is characterized by multiple metabolic abnormalities including the dysfunction of pancreatic islet cells. Current treatment options have different mechanisms of action and are variably effective at lowering blood glucose levels. The newest pharmacologic treatments, incretin mimetics and dipeptidyl peptidase-IV (DPP-4) inhibitors, target the incretin system, and it is important to understand their role in current treatment paradigms and in addressing the basic pathophysiology of type 2 diabetes—pancreatic islet cell dysfunction.

Conclusion

This article discusses the pathophysiology of type 2 diabetes including impairment of the incretin effect, and explains how incretin mimetics and DPP-4 inhibitors are being incorporated into treatment algorithms to address pancreatic islet cell dysfunction and enable patients to achieve glycemic targets.

The Diabetes Educator, Vol. 35, No. Supplement 1, 4S-11S (2009)
DOI: 10.1177/0145721709331522
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