J Korean Diabetes.  2022 Sep;23(3):153-156. 10.4093/jkd.2022.23.3.153.

Extent of Role: Anti-Diabetic Medications

• Hong JH

• KMID: 2534300
• DOI: http://doi.org/10.4093/jkd.2022.23.3.153

Abstract

In management of diabetes, glucose lowering is the basic target of treatment. Insulin is essential to type 1 diabetes. Non-insulin therapy in type 2 diabetes is very diverse and continuously developing to improve glucose control and prevent diabetes-related complications. In the recent 30 years, recommended specifications of anti-diabetic drugs are high glucose-lowering efficacy, low risk of hypoglycemia, less burden of weight gain, and cardiovascular safety. With development of SGLT2 inhibitors (sodium glucose cotransporter 2 inhibitors) and GLP-1RA (glucagon-like peptide-1 receptor agonist), the clinical benefits also include risk reduction of diabetes-related complications (hospitalization for heart failure, chronic kidney disease, atherosclerotic cardiovascular disease), even in non-diabetic patients. Anti-diabetic medication can have a role in holistic management for prevention and treatment of diabetes and diabetes-related complications, as well as an improvement of mortality.

Keyword

Complications; Diabetes mellitus; type 2; Glucose; Mortality

Reference

1.Ziegler AG., Danne T., Daniel C., Bonifacio E. 100 years of insulin: lifesaver, immune target, and potential remedy for prevention. Med (N Y). 2021. 2:1120–37.

2.Khan Y., Albache N., Almasri I., Gabbay RA. The management of diabetes in conflict settings: focus on the Syrian crisis. Diabetes Spectr. 2019. 32:264–9.

3.Holman RR., Paul SK., Bethel MA., Matthews DR., Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008. 359:1577–89.

4.Action to Control Cardiovascular Risk in Diabetes Study Group., Gerstein HC., Miller ME., Byington RP., Goff DC Jr., Bigger JT, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008. 358:2545–59.

5.American Diabetes Association Professional Practice Committee., Draznin B., Aroda VR., Bakris G., Benson G., Brown FM, et al. 9. Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022. 45(Suppl 1):S125–43.

6.Korean Diabetes Association. Clinical practice guidelines for diabetes. 7th ed.Seoul: Korean Diabetes Association;2021.

7.Heerspink HJL., Stefánsson BV., Correa-Rotter R., Chertow GM., Greene T., Hou FF, et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med. 2020. 383:1436–46.

8.McMurray JJV., Solomon SD., Inzucchi SE., Køber L., Kosi-borod MN., Martinez FA, et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med. 2019. 381:1995–2008.

9.O'Hara DV., Jardine MJ. SGLT2 inhibitors may prevent diabetes. Nat Rev Nephrol. 2022. 18:203–4.

10.Patorno E., Najafzadeh M., Pawar A., Franklin JM., Déru-az-Luyet A., Brodovicz KG, et al. The EMPagliflozin com-paRative effectIveness and SafEty (EMPRISE) study pro-gramme: design and exposure accrual for an evaluation of empagliflozin in routine clinical care. Endocrinol Diabetes Metab. 2019. 3:e00103.

11.le Roux CW., Astrup A., Fujioka K., Greenway F., Lau DCW., Van Gaal L, et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet. 2017. 389:1399–409. Erratum in: Lancet 2017;389):1398.

12.Jastreboff AM., Aronne LJ., Ahmad NN., Wharton S., Con-nery L., Alves B, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022. 387:205–16.