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(Circulation. 2008;117:574-584.)
© 2008 American Heart Association, Inc.

New Drugs and Technologies

New Drugs for the Treatment of Diabetes

Part II: Incretin-Based Therapy and Beyond

Silvio E. Inzucchi, MD; Darren K. McGuire, MD, MHSc

From the Section of Endocrinology, Yale University School of Medicine, New Haven, Conn (S.E.I.), and Cardiovascular Division and the Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas (D.K.M.).

Correspondence to Silvio E. Inzucchi, MD, Section of Endocrinology, Yale University School of Medicine, New Haven, CT 06520–8020. E-mail silvio.inzucchi{at}yale.edu

This is the second of a 2-part series focusing on newer therapies for type 2 diabetes and their cardiovascular implications. In the first segment, we reviewed the thiazolidinediones, highlighting emerging data concerning their cardiovascular effects, both positive and negative. Here, we present a corresponding discussion of the newest antihyperglycemic category, modulators of the incretin system, which include the glucagon-like peptide-1 mimetics and the dipeptidyl peptidase-4 inhibitors. In addition, we briefly survey several novel drug classes in development, provide summary recommendations for glucose-lowering regimens in specific patient types, underscore the importance of nonglucose cardiovascular risk reduction strategies, and comment on present and future considerations for the regulatory review of diabetes drugs.

Key Words: coronary disease • diabetes mellitus • drugs • heart failure • incretins