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World J Diabetes. Sep 15, 2016; 7(17): 354-395
Published online Sep 15, 2016. doi: 10.4239/wjd.v7.i17.354
Update on the treatment of type 2 diabetes mellitus
Juan José Marín-Peñalver, Iciar Martín-Timón, Cristina Sevillano-Collantes, Francisco Javier del Cañizo-Gómez
Juan José Marín-Peñalver, Iciar Martín-Timón, Cristina Sevillano-Collantes, Francisco Javier del Cañizo-Gómez, Section of Endocrinology, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, 28031 Madrid, Spain
Author contributions: Marín-Peñalver JJ, Martín-Timón I, Sevillano-Collantes C and del Cañizo-Gómez FJ contributed equally to this work.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Francisco Javier del Cañizo-Gómez, Professor of Medicine, Chief of Endocrinology Section, Section of Endocrinology, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Avda Gran Vía del Este 80, 28031 Madrid, Spain. fjcanizog@salud.madrid.org
Telephone: +34-91-1918000 Fax: +34-91-1918878
Received: March 29, 2016
Peer-review started: March 30, 2016
First decision: May 17, 2016
Revised: July 2, 2016
Accepted: July 20, 2016
Article in press: July 22, 2016
Published online: September 15, 2016
Processing time: 165 Days and 20.1 Hours
Abstract

To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2DM, with an emphasis on agents introduced within the last decade.

Keywords: Type 2 diabetes mellitus; Treatment; Oral antidiabetic agents; Injectable antidiabetic agents; Older people; Renal impairment; Future treatments

Core tip: To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. This article reviews current and future treatments for patients with type 2 diabetes mellitus, its use in clinical practice and in special situations such as kidney failure and elderly patient, with an emphasis on agents introduced within the last decade.