Clinical management strategies for type 2 diabetes.

Incretin therapeutics address an unmet need in diabetes by effectively treating postprandial glycemia. In addition, they present interesting possibilities for future therapy as they were suggested in preclinical studies to have effects on pancreatic beta-cell neogenesis. When used in combination with metformin, sulfonylureas, or TZDs, GLP-1 analogs such as exenatide and DPP-IV inhibitors such as sitagliptin reduce A1C, fasting glucose levels, and postprandial glucose levels with few additional adverse events. Incretin therapeutics is a relatively young field, and much remains to be discovered. It is to be hoped that as trial data accumulate they will demonstrate that these agents will improve overall glycemic control in those with type 2 diabetes. The possibility that they may also be able to affect the course of this devastating metabolic disorder should also be fully explored.