In recent years, significant progress has been made in the management of type 2 diabetes mellitus. In the field of incretin-based therapies, linagliptin is a novel DPP-4 inhibitor which is eliminated by a hepatic-biliary route, as a result no dose adjustment is needed in patients with type 2 diabetes and renal impairment. Two novel GLP-1 Receptor Agonists have emerged as promising new options for the treatment of type 2 diabetes mellitus, lixisenatide a short acting GLP-1 Receptor Agonist and exenatide long-acting release.
SGLT-2 inhibitors are a relatively new family of glucose-lowering agents that inhibit the sodium-glucose co-transporter. They reduce plasma glucose levels by increasing urinary glucose excretion. These agents can partially reduce body weight and blood pressure of the patients. The known adverse effects of SGLT-2 inhibitors include an increased risk of fungal genital infections.
New developments in the field of insulin therapy include insulin degludec, a new ultra-long-acting basal insulin with a duration of action that lasts up to 48 hours. Insulin degludec lowers rates of hypoglycemia and narrows the day-to-day glucose variability. The combination of basal insulin and GLP-1 receptor agonist is a new and attractive therapeutic perspective in type 2 diabetes.