Abstract:
Over the past century, since the discovery of insulin, the therapeutic offer for diabetes has grown exponentially, in particular for type 2 diabetes (T2D). However, the drugs in the diabetes pipeline are even more promising because of their impressive antihyperglycemic effects coupled with remarkable weight loss. An ideal medication for T2D should target not only hyperglycemia but also insulin resistance and obesity. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and the new class of GLP1 and gastric inhibitory polypeptide dual RAs counteract 2 of these metabolic defects of T2D, hyperglycemia and obesity, with stunning results that are similar to the effects of metabolic surgery. An important role of antidiabetic medications is to reduce the risk and improve the outcome of cardiovascular diseases, including coronary artery disease and heart failure with reduced or preserved ejection fraction, as well as diabetic nephropathy, as shown by SGLT2 inhibitors. This review summarizes the main drugs currently under development for the treatment of type 1 diabetes and T2D, highlighting their strengths and side effects.
摘要:
在过去的一个世纪里,自从发现胰岛素以来,糖尿病的治疗方案呈指数级增长,特别是2型糖尿病(T2D)。然而,糖尿病管道中的药物更有前景,因为它们令人印象深刻的抗高血糖作用以及显著的体重减轻。T2D的理想药物不仅应针对高血糖,还应针对胰岛素抵抗和肥胖。胰高血糖素样肽-1受体激动剂(GLP-1RAs)和新类型的GLP1和抑胃多肽双重RAs抵消了2个T2D的这些代谢缺陷,高血糖和肥胖,与代谢手术效果相似的惊人结果。抗糖尿病药物的重要作用是降低心血管疾病的风险并改善其预后。包括冠状动脉疾病和心力衰竭,射血分数降低或保留,以及糖尿病肾病,如SGLT2抑制剂所示。本文综述了目前正在开发的治疗1型糖尿病和T2D的主要药物,强调他们的优势和副作用。