Bromocriptine--unique formulation of a dopamine agonist for the treatment of type 2 diabetes.

IMPORTANCE TO THE FIELD: There is a large unmet need for new therapies to treat type 2 diabetes (T2DM) which reduce fasting and postprandial glucose without increasing insulin levels and which are not associated with weight gain or hypoglycemia. The quick-release formulation of bromocriptine (bromocriptine-QR; Cycloset) represents such a therapy. AREAS COVERED IN THE REVIEW: Bromocriptine-QR's proposed mechanism of action, unique formulation and clinical efficacy and safety will be discussed. A Medline search was conducted using the terms: bromocriptine quick-release, circadian rhythms, treatment type 2 diabetes, insulin resistance, beta-cell dysfunction (years 1985 - 2009). WHAT THE READER WILL GAIN: The reader will gain an understanding of the importance of the brain as a target for the treatment of type 2 diabetes. In addition the safety, efficacy and indication for use of a first-in-class dopamine agonist as a treatment option for type 2 diabetes are discussed. TAKE HOME MESSAGE: Bromocriptine-QR is indicated to be used alone or in conjunction with all available treatments for type 2 diabetes. Although the mechanism of action is not fully understood, bromocriptine-QR's action points to a central target in the brain (hypothalamus) which may explain the observed peripheral improvements in metabolic parameters.