New therapeutic options in the treatment of diabetes mellitus.

Abstract

Although a number of compounds exist for the treatment of diabetes mellitus, euglycemia in many patients is still difficult or impossible to achieve. Many patients are insulin resistant, a condition that is not adequately remedied either by sulfonylureas or insulin, and usually worsens over time. In addition, there are patients that, although their fasting blood glucose is controlled, experience unacceptable postprandial glucose excursions. The newer compounds that are either approved or under development possess more novel mechanisms of action that may contribute to their efficacy in these patients. The agents reviewed in this article include those that attenuate postprandial glucose elevations by mechanisms such as delayed gastric emptying and enzyme inhibition, and those that directly increase insulin sensitivity.