Management of type 2 diabetes: new and future developments in treatment.

To date, six classes of oral medication have been approved by the U.S. Food and Drug Administration for the treatment of type 2 diabetes and several new agents are in the pipeline. In 2009, the American Diabetes Association and the European Association for the Study of Diabetes developed a consensus statement regarding the treatment of type 2 diabetes, citing lifestyle modification and metformin as the preferred first line therapies. In addition to the currently available drugs, several new agents have recently been introduced or are in the development pipeline. Incretin therapies include both glucagon-like peptide-1 (GLP-1) inhibitors and dipeptidyl peptidase 4 (DPP-4) inhibitors. Non-incretin beta cell stimulants still in development include glucokinase activators, G-protein-coupled receptors, and anti-inflammatory and anti-oxidant therapies. Additional agents that target glucose synthesis include glucose-6-phosphatase and glycogen phosphorylase. Other new agents target metabolic syndrome, which is often the first clinical condition that presents in patients at risk for type 2 diabetes. Finally, for obese patients who are unable to lose weight through diet and exercise, weight-loss surgery is an option that should be discussed with their physicians. This CME multimedia activity, which is part of a 2-part multimedia activity on the management and treatment of diabetes, contains a video presentation and is available through the website of The American Journal of Medicine at http://amjmed.com/content/multimedia. Click on "Management of Type 2 Diabetes: New and Future Developments in Treatment" to access this part of this multimedia program.