Management of type 2 diabetes: new and future developments in treatment

Abd Tahrani, CJ Bailey, S Del Prato, Anthony Barnett

Research output: Contribution to journalArticle

383 Citations (Scopus)


The increasing prevalence, variable pathogenesis, progressive natural history, and complications of type 2 diabetes emphasise the urgent need for new treatment strategies. Longacting (eg, once weekly) agonists of the glucagon-like-peptide-1 receptor are advanced in development, and they improve prandial insulin secretion, reduce excess glucagon production, and promote satiety. Trials of inhibitors of dipeptidyl peptidase 4, which enhance the effect of endogenous incretin hormones, are also nearing completion. Novel approaches to glycaemic regulation include use of inhibitors of the sodium glucose cotransporter 2, which increase renal glucose elimination, and inhibitors of 11 beta-hydroxysteroid dehydrogenase 1, which reduce the glucocorticoid effects in liver and fat. Insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, and metabolic inhibitors of hepatic glucose output are being assessed. Early proof of principle has been shown for compounds that enhance and partly mimic insulin action and replicate some effects of bariatric surgery.
Original languageEnglish
Pages (from-to)182-197
Number of pages16
Issue number9786
Publication statusPublished - 1 Jul 2011


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