Erschienen in:
01.09.2009 | Review Article
Is the current therapeutic armamentarium in diabetes enough to control the epidemic and its consequences? What are the current shortcomings?
verfasst von:
Dario Giugliano, Eberhard Standl, Tina Vilsbøll, John Betteridge, Riccardo Bonadonna, Ian W. Campbell, Gerit-Holger Schernthaner, Bart Staels, Antonia Trichopoulou, Eduardo Farinaro
Erschienen in:
Acta Diabetologica
|
Ausgabe 3/2009
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Abstract
The prevalence of diabetes is expected to rise together with an increase in morbidity and a reduction in life expectancy. A leading cause of death is cardiovascular disease, and hypertension and diabetes are additive risk factors for this complication. Selected treatment options should neither increase cardiovascular risk in patients with diabetes, nor increase risk of hyperglycaemia in patients with hypertension. The efficacy of present antihyperglycaemic agents is limited and new therapies, such as incretin-targeted agents, are under development. Even though most patients do not achieve glycated haemoglobin targets, trial data show that such interventions reduce the incidence of macrovascular events; however, intensive lowering may be detrimental in patients with existing cardiovascular disease. Currently available oral drugs do not address the key driver of type 2 diabetes—loss of functional beta-cell mass. In the future, new oral treatments must improve this, whilst providing durable blood glucose control and long-term tolerability.