Drug Therapies for Improving Type 2 Diabetes Outcomes

Saturday, October 19 at 2:45 pm

LAS VEGAS—There are now 12 classes of antihyperglycemic medications for clinicians to consider when developing a treatment plan for diabetes patients. Incretin-based therapies and sodium-glucose cotransporter-2 (SGLT-2) inhibitors will be the focus of tomorrow’s workshop by Mark E. Molitch, MD, titled, “Recent and Emerging Therapies in Type 2 Diabetes.”

Molitch, professor in the division of endocrinology, metabolism and molecular medicine at Northwestern University Feinberg School of Medicine, will describe the potential role of new and emerging incretin-based type 2 diabetes pharmacotherapies in improving clinical outcomes. Incretin-based therapies are divided into the oral agents dipeptidyl peptidase-4 inhibitors (DPP-4) and the injectable glucagon-like peptide-1 (GLP-1) receptor agonists.

“DPP-4 are less potent, but pretty well tolerated,” he explained. “GLP-1 receptor agonists are more potent and often associated with weight loss, but have the disadvantage of requiring one or 2 injections per day.”

Molitch will also discuss the impact of SGLT-2 inhibition on renal glucose handling and treatment outcomes. SGLT-2 inhibitors reduce glucose reabsorption in the kidney, resulting in decreased blood glucose levels, decreased weight, and a slight increase in mycotic infections.

“The SGLT-2 inhibitors are in a new class of drug and allow for more choices in treatment,” said Molitch. “The first-line treatment is usually lifestyle change plus metformin and then another medication can be added. The SGLT-2 inhibitors will likely fall into this second tier. They have the advantage of providing weight loss and blood pressure lowering, in addition to helping glucose control.”

The workshop will conclude with a review of agents currently in the pipeline. Along with new drugs being added to the classes currently available, new longer-acting insulin analogs are coming that provide similar glycemic lowering with less hypoglycemia (ie, glargine U300 and degludec). Furthermore, new oral agents with novel mechanisms of action are also under investigation.

- Eileen Koutnik-Fotopoulos