PMID- 33463546
OWN - NLM
STAT- MEDLINE
DCOM- 20210909
LR  - 20231104
IS  - 1558-8238 (Electronic)
IS  - 0021-9738 (Print)
IS  - 0021-9738 (Linking)
VI  - 131
IP  - 2
DP  - 2021 Jan 19
TI  - Pharmacological treatment of hyperglycemia in type 2 diabetes.
LID - 142243 [pii]
LID - 10.1172/JCI142243 [doi]
LID - e142243
AB  - Diabetes mellitus is a major public health problem, affecting about 10% of the 
      population. Pharmacotherapy aims to protect against microvascular complications, 
      including blindness, end-stage kidney disease, and amputations. Landmark clinical 
      trials have demonstrated that intensive glycemic control slows progression of 
      microvascular complications (retinopathy, nephropathy, and neuropathy). Long-term 
      follow-up has demonstrated that intensive glycemic control also decreases risk of 
      macrovascular disease, albeit rigorous evidence of macrovascular benefit did not 
      emerge for over a decade. The US FDA's recent requirement for dedicated 
      cardiovascular outcome trials ushered in a golden age for understanding the 
      clinical profiles of new type 2 diabetes drugs. Some clinical trials with 
      sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide 1 
      (GLP1) receptor agonists reported data demonstrating cardiovascular benefit 
      (decreased risk of major adverse cardiovascular events and hospitalization for 
      heart failure) and slower progression of diabetic kidney disease. This Review 
      discusses current guidelines for use of the 12 classes of drugs approved to 
      promote glycemic control in patients with type 2 diabetes. The Review also 
      anticipates future developments with potential to improve the standard of care: 
      availability of generic dipeptidylpeptidase-4 (DPP4) inhibitors and SGLT2 
      inhibitors; precision medicine to identify the best drugs for individual 
      patients; and new therapies to protect against chronic complications of diabetes.
FAU - Taylor, Simeon I
AU  - Taylor SI
FAU - Yazdi, Zhinous Shahidzadeh
AU  - Yazdi ZS
FAU - Beitelshees, Amber L
AU  - Beitelshees AL
LA  - eng
GR  - P30 DK072488/DK/NIDDK NIH HHS/United States
GR  - R01 DK118942/DK/NIDDK NIH HHS/United States
GR  - T32 DK098107/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - J Clin Invest
JT  - The Journal of clinical investigation
JID - 7802877
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (GLP1R protein, human)
RN  - 0 (Glucagon-Like Peptide-1 Receptor)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
SB  - IM
MH  - Diabetes Complications/*drug therapy/metabolism
MH  - Diabetes Mellitus, Type 2/*drug therapy/metabolism/pathology
MH  - Dipeptidyl-Peptidase IV Inhibitors/*therapeutic use
MH  - Glucagon-Like Peptide-1 Receptor/agonists/metabolism
MH  - Glycemic Control
MH  - Heart Failure/*drug therapy/etiology/metabolism
MH  - Humans
MH  - Hyperglycemia/*drug therapy/pathology
MH  - Sodium-Glucose Transporter 2 Inhibitors/*therapeutic use
PMC - PMC7810496
COIS- Conflict of interest: SIT serves as a paid consultant for Ionis Pharmaceuticals; 
      was previously employed by Bristol Myers Squibb, where he contributed to R&D on 
      saxagliptin and dapagliflozin; and is an inventor on patents covering (a) the use 
      of metreleptin as a treatment for lipodystrophy (US8318666B2) and (b) the use of 
      fusion proteins containing fibronectin-derived serum albumin binding domains to 
      extend the pharmacokinetics of therapeutic proteins (US9540424B2).
EDAT- 2021/01/20 06:00
MHDA- 2021/09/10 06:00
PMCR- 2022/01/19
CRDT- 2021/01/19 08:41
PHST- 2021/01/19 08:41 [entrez]
PHST- 2021/01/20 06:00 [pubmed]
PHST- 2021/09/10 06:00 [medline]
PHST- 2022/01/19 00:00 [pmc-release]
AID - 142243 [pii]
AID - 10.1172/JCI142243 [doi]
PST - ppublish
SO  - J Clin Invest. 2021 Jan 19;131(2):e142243. doi: 10.1172/JCI142243.