New Mechanisms in Glucose Control E-Book

Anthony H. Barnett

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 114

Veröffentlichungsjahr: 2013

Beschreibung

New Mechanisms in Glucose Control presents a clear overview of the new drugs and treatment therapies that have been developed in recent years to help improve glycaemic  management for the diabetic patient, namely the incretin mimetics (GLP-1 agonists) and DPP-4 inhibitors. It also considers other drug classes currently in development and undergoing clinical trials including the SGLT2 inhibitors and other pipeline products. In addition to pharma cotherapeutic agents, the role of bariatric as a management tool for diabetes is covered as well as consideration of the organisation of diabetes care with a community focus.

This indispensable pocketbook details the newer treatments and offers a comparison with more traditional agents including sulphonyureas, glitazones and insulin. The pros and cons of traditional therapies are discussed as well as the epidemiology and pathogenesis of type 2 diabetes, helping to give the reader a better understanding of the disease area and its management.  

New Mechanisms in Glucose Control is essential reading for health professionals working in primary or secondary care and involved in treating diabetic patients.

Leseprobe

Contents

Preface

Chapter 1 Epidemiology and Pathogenesis of Type 2 Diabetes

The current prevalence of diabetes

Factors driving the type 2 diabetes epidemic

Pathogenesis of type 2 diabetes

References

Chapter 2 Overview of Current Diabetes Management

Recommended targets for glycaemic control

Pros and cons of existing non-insulin antidiabetes therapies

Why are new drugs needed for the treatment of type 2 diabetes?

References

Chapter 3 The Incretin System

References

Chapter 4 The Incretin Mimetics

Exenatide

Liraglutide

Place in therapy of the incretin mimetics

References

Chapter 5 Dipeptidyl Peptidase-4 Inhibitors

Mechanism of action

DPP-4 inhibitor clinical efficacy

Vildagliptin

Saxagliptin

DPP-4 inhibitor safety and tolerability

DPP-4 inhibitor advantages and disadvantages

DPP-4 inhibitor current indications

Place in therapy of the DPP-4 inhibitors

References

Chapter 6 Sodium-glucose Cotransporter-2 Inhibitors

Dapagliflozin

Safety and tolerability

SGLT-2 inhibitor advantages and disadvantages

References

Chapter 7 Pipeline Diabetes Therapies

Taspoglutide

Linagliptin

Bile acid receptor agonists

Glucokinase activators

Sirtuins

Sodium-glucose cotransporter-1 inhibitors

Sodium-glucose cotransporter-2 antisense inhibitors

Glucose-dependent insulinotropic polypeptide agonists and antagonists

Glucagon receptor antagonists

References

Chapter 8 Bariatric Surgery for the Treatment of Type 2 Diabetes

Potential mechanisms of diabetes resolution after bariatric surgery

Efficacy of bariatric surgery for the treatment of type 2 diabetes

Considerations

References

Chapter 9 Organization of Diabetes Care

Managing diabetes in primary care

Delivery of diabetes care closer to home

Structured patient education programmes

References

Index

This edition first published 2011, © Anthony H. Barnett and Jenny Grice

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1 2011

Preface

Whilst insulin was first isolated in 1921 and produced commercially by 1923, it was not until the mid 1950s that oral agents for type 2 diabetes came to the market, first sulphonylureas and then the first biguanide. We then waited another 30 years for the first alpha-glucosidase inhibitor, but since then there has been a veritable explosion in interest for new drugs in the diabetes market with a number now commercially available.

It is clear that the traditional agents remain important therapies, but they have their downside from the point of view of tolerability/side-effect problems. Moreover, they appear not to influence the natural history of the disease. The latter is an important issue given the progressive nature of type 2 diabetes and the need to achieve good glycaemic control to reduce the risk of devastating long-term vascular complications.

In the past few decades a revolution in our approach to treating type 2 diabetes has occurred following the recognition that the disease is caused by multiple defects. A range of new treatments are now available with differing mechanisms of action, and many more are in the pipeline, which will allow us to target this multifactorial disease more effectively than ever before.

The increasing requirement in the UK to move much of diabetes practice into the community requires a much more detailed knowledge of the condition by GPs and practice nurses. In this bespoke book, the authors aim to show how new mechanisms of glucose control and advances in treatments arising from this can be translated into primary care. The book will cover the epidemiology and pathogenesis of type 2 diabetes as well as provide an overview of current diabetes management including the pros and cons of traditional therapies. This will be followed by an in-depth discussion of the incretin system and the new drugs based on this approach – the incretin mimetics (glucagon-like peptide-1 (GLP-1) agonists) and dipeptidyl peptidase-4 (DPP-4) inhibitors. The authors will also review other drug classes in development as well as discussing the often observed resolution of type 2 diabetes that occurs after weight-loss surgery. Finally, they will consider effective approaches for diabetes care within that arena.

This book is particularly timely given the recent guidelines from the National Institute for Health and Clinical Excellence (NICE) on Newer Agents for Blood Glucose Control in Type 2 Diabetes, and is intended primarily for the multi-professional diabetes care team. It should, however, also be of interest to hospital specialists in training and other relevant staff. It is hoped that by increasing awareness of the expanding therapeutic options for type 2 diabetes and their mechanisms, we can better target the multitude of physiological defects that characterize the disease and customize treatment regimens to fit the individual needs of each patient.

Anthony H. Barnett

Birmingham