Pharmacotherapy of type 2 diabetes: An update

Jagriti Upadhyay; Stergios A Polyzos; Nikolaos Perakakis; Bindiya Thakkar; Stavroula A Paschou; Niki Katsiki; Patricia Underwood; Kyung-Hee Park; Jochen Seufert; Eun Seok Kang; Elliot Sternthal; Asterios Karagiannis; Christos S Mantzoros

doi:10.1016/j.metabol.2017.08.010

Pharmacotherapy of type 2 diabetes: An update

Metabolism. 2018 Jan:78:13-42. doi: 10.1016/j.metabol.2017.08.010. Epub 2017 Sep 8.

Affiliations

¹ Section of Endocrinology, Diabetes and Metabolism, Boston VA Healthcare System, Boston, MA, USA; Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. Electronic address: jupadhya@bidmc.harvard.edu.
² First Department of Pharmacology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
³ Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Divisions of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Freiburg, Germany.
⁴ Section of Endocrinology, Diabetes and Metabolism, Boston VA Healthcare System, Boston, MA, USA.
⁵ Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
⁶ Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
⁷ Department of Family Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, Republic of Korea.
⁸ Divisions of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Freiburg, Germany.
⁹ Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
¹⁰ Section of Endocrinology, Diabetes and Metabolism, Boston VA Healthcare System, Boston, MA, USA; Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

PMID: 28920861
DOI: 10.1016/j.metabol.2017.08.010

Abstract

Type 2 diabetes (T2DM) is a leading cause of morbidity and mortality worldwide and a major economic burden. The prevalence of T2DM is rising, suggesting more effective prevention and treatment strategies are necessary. The aim of this narrative review is to summarize the pharmacologic treatment options available for patients with T2DM. Each therapeutic class is presented in detail, outlining medication effects, side effects, glycemic control, effect on weight, indications and contraindications, and use in selected populations (heart failure, renal insufficiency, obesity and the elderly). We also present representative cost for each antidiabetic category. Then, we provide an individualized guide for initiation and intensification of treatment and discuss the considerations and rationale for an individualized glycemic goal.

Keywords: Algorithm; Goals pharmacotherapy; Personalized therapy; Type 2 diabetes.

Publication types

Review

MeSH terms

Animals
Blood Glucose / drug effects
Diabetes Mellitus, Type 2 / drug therapy*
Humans
Hypoglycemic Agents

Substances

Blood Glucose
Hypoglycemic Agents