{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:13:40Z","timestamp":1761894820934},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"853","license":[{"start":{"date-parts":[[1996,11,1]],"date-time":"1996-11-01T00:00:00Z","timestamp":846806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1996,11,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>In subjects with type 2 diabetes, both defects of insulin secretion and insulin resistance contribute to the development of hyperglycaemia. The major goals of treatment are to optimise blood glucose control, and normalise the associated lipid disturbances and elevated blood pressure. Pharmacologic treatment is often necessary. This paper discusses new forms of oral treatment for subjects with type 2 diabetes. These include a new sulphonylurea compound glimepiride (Amaryl), which binds to a different protein of the putative sulphonylurea receptor than glibenclamide, and seems to have a lower risk of hypoglycaemia. A new class of drugs with insulin secretory capacity, of which repaglinide (NovoNorm) is the leading compound, is now in phase III clinical trials. Alpha-glucosidase inhibitors reversibly inhibit alpha-glucosidase enzymes in the small intestine, which delays cleavage of oligo- and disaccharides to monosaccharides. This leads to a delayed and reduced blood glucose rise after a meal. Two compounds are in development or have been marketed, ie, miglitol and acarbose (Glucobay). Another new class of drugs is the thiazolidine-diones, which seem to work by enhancing insulin action. The \u2018insulin sensitising\u2019 effects of the leading compounds, troglitazone and BRL 49653C, do not involve any effect on insulin secretion. These drugs also seem to beneficially influence serum cholesterol and triglyceride levels. Oral antihyperglycaemic agents can be used only during a limited period of time in most patients, after which the diabetic state \u2018worsens\u2019 and insulin therapy has to be started. In this light, two new forms of treatment which require subcutaneous injections are also discussed: the synthetic human amylin analogue AC137 (pramlintide) and glucagon-like peptide-1 (7-36)-amide, a strong glucose-dependent stimulator of insulin secretion. It remains to be seen whether these compounds can be developed further for clinical use in patients with diabetes.<\/jats:p>","DOI":"10.1136\/pgmj.72.853.657","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:49:00Z","timestamp":1230587340000},"page":"657-662","source":"Crossref","is-referenced-by-count":24,"title":["New treatments for patients with type 2 diabetes mellitus"],"prefix":"10.1093","volume":"72","author":[{"given":"B H","family":"Wolffenbuttel","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, University Hospital Maastricht, University of Limburg , PO Box 5800, 6202 AZ Maastricht , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M B","family":"Graal","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University Hospital Maastricht, University of Limburg , PO Box 5800, 6202 AZ Maastricht , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1996,11,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1464-5491.1988.tb00984.x","article-title":"Management of noninsulin-dependent diabetes mellitus in Europe: a consensus view","volume":"5","author":"Alberti, K.G.M.M.; Gries, F.A.","year":"1988","unstructured":"Alberti KGMM, Gries FA. Management of noninsulin-dependent diabetes mellitus in Europe: a consensus view. Diabetic Med 1988; 5: 275 - 81.","journal-title":"Diabetic Med"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1007\/BF00870275","article-title":"Diabetic control and microvascular complications: the near-normoglycaemic experience","volume":"29","year":"1986","unstructured":"Hanssen KF, Dahl-Jorgensen K, Lauritzen T, Feldt-Rasmusssen B, Brinckmann-Hansen 0, Deckert T. Diabetic control and microvascular complications: the near-normoglycaemic experience. Diabetologia 1986; 29: 677-81.","journal-title":"Diabetologia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/BF00418270","article-title":"Effect of improved metabolic control on loss of kidney function in type I (insulin-dependent) diabetic patients: an update of the Steno studies","volume":"34","author":"Feldt-Rasmussen, B.; Mathiesen, E.R.; Jensen, T.; Lauritzen, T.; Deckert, T.","year":"1991","unstructured":"Feldt-Rasmussen B, Mathiesen ER, Jensen T, Lauritzen T, Deckert T. Effect of improved metabolic control on loss of kidney function in type I (insulin-dependent) diabetic patients: an update of the Steno studies. 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Eur Jf Clin Invest 1994; 24 (suppl 3): 36-9.","journal-title":"Eur Jf Clin Invest"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"732","DOI":"10.2337\/diacare.14.8.732","article-title":"Therapeutic potentials of acarbose as first line drug in non-insulin dependent diabetes insufficiently treated with diet alone","volume":"14","author":"Hanefeld, M.; Fischer, S.; Schulze, J.","year":"1991","unstructured":"Hanefeld M, Fischer S, Schulze J, et al. Therapeutic potentials of acarbose as first line drug in non-insulin dependent diabetes insufficiently treated with diet alone. Diabetes Care 1991; 14: 732-7.","journal-title":"Diabetes Care"},{"key":"ref_22","first-page":"1677","article-title":"Acarbose for the treatment of type II diabetes: the results of a Canadian multi-centre trial","volume":"28","author":"Josse, R.G.","year":"1995","unstructured":"Josse RG. Acarbose for the treatment of type II diabetes: the results of a Canadian multi-centre trial. Diabetes Res Clint Pract 1995; 28 (suppl): S 1677-72.","journal-title":"Diabetes Res Clint Pract"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"478","DOI":"10.2337\/diacare.15.4.478","article-title":"Alpha-glucosidase inhibition by miglitol in NIDDM patients","volume":"15","author":"Kingma, P.J.; Menheere, P.P.C.A.; Sels, J.P.; Nieuwenhuijzen Kruseman, A.C.","year":"1992","unstructured":"Kingma PJ, Menheere PPCA, Sels JP, Nieuwenhuijzen Kruseman AC. Alpha-glucosidase inhibition by miglitol in NIDDM patients. Diabetes Care 1992; 15: 478-83.","journal-title":"Diabetes Care"},{"key":"ref_24","article-title":"Miglitol (Bay m 1099) has no extrapancreatic effects in healthy volunteers","author":"Sels, J.P.J.E.; J]P, Nauta; Menheere, P.P.C.A.; Wolffenbuttel, B.H.R.; Nieuwenhuijzen Kruseman, A.C.","year":"1996","unstructured":"Sels JPJE, Nauta J]P, Menheere PPCA, Wolffenbuttel BHR, Nieuwenhuijzen Kruseman AC. Miglitol (Bay m 1099) has no extrapancreatic effects in healthy volunteers. BrJ Clin Pharmacol 1996; (in press).","journal-title":"BrJ Clin Pharmacol"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.2337\/diacare.15.8.1075","article-title":"New oral thiazolidinedione antidiabetic agents act as insulin sensitizers","volume":"15","author":"Hofmann, C.A.; Colca, JR","year":"1992","unstructured":"Hofmann CA, Colca JR. New oral thiazolidinedione antidiabetic agents act as insulin sensitizers. Diabetes Care 1992; 15: 1075-8.","journal-title":"Diabetes Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3977","DOI":"10.1021\/jm00049a017","article-title":"[[w-(Heterocyclylamino)-alkoxy]benzyl]-2,4thiazolidinediones as potent antihyperglycemic agents","volume":"37","author":"Cantello, B.C.C.; Cawthorne, M.A.; Cottam, G.P.","year":"1994","unstructured":"Cantello BCC, Cawthorne MA, Cottam GP, et al. 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One-year clinical trial of a new oral hypoglycemic agent, CS-045, in NIDDM patients","volume":"37","author":"Kuzuya, T.; Kosaka, K.; Akanuma, Y.; Shigeta, Y.; Kaneko, T.; Shimizu, N.","year":"1994","unstructured":"Kuzuya T, Kosaka K, Akanuma Y, Shigeta Y, Kaneko T, Shimizu N. CS-045 Study Group. One-year clinical trial of a new oral hypoglycemic agent, CS-045, in NIDDM patients. Diabetologia 1994; 37 (suppl ): A63.","journal-title":"Diabetologia"},{"key":"ref_31","first-page":"316","article-title":"Enhancement of insulin sensitivity by troglitazone lowers blood pressure in diabetic hypertensives","volume":"8","author":"Ogihara, T.; H., Rakugi; Ikegami, H.; Mikami, H.; Masuo, K.","year":"1995","unstructured":"Ogihara T, Rakugi H., Ikegami H, Mikami H, Masuo K. Enhancement of insulin sensitivity by troglitazone lowers blood pressure in diabetic hypertensives. AmJIHypertens 1995; 8: 316-20.","journal-title":"AmJIHypertens"},{"issue":"1","key":"ref_32","first-page":"57","article-title":"Troglitazone as an antioxidant","volume":"44","author":"Dandona, P.; Khurana, U.; Aljada, A.; AbdelRahman, E.; Love, J.","year":"1995","unstructured":"Dandona P, Khurana U, Aljada A, AbdelRahman E, Love J. Troglitazone as an antioxidant. Diabetes 1995; 44 (suppl 1): 57A.","journal-title":"Diabetes"},{"issue":"1","key":"ref_33","first-page":"157","article-title":"Treatment of NIDDM patients with troglitazone is not associated with increased cardiac mass or impaired cardiac function","volume":"44","author":"Ghazzi, M.; Balagtas, C.; Perez, J.; Whitcomb, R.","year":"1995","unstructured":"Ghazzi M, Balagtas C, Perez J, Whitcomb R. Treatment of NIDDM patients with troglitazone is not associated with increased cardiac mass or impaired cardiac function. Diabetes 1995; 44 (suppl 1): 157A.","journal-title":"Diabetes"},{"issue":"1","key":"ref_34","first-page":"32","article-title":"Infusion of the human amylin analogue, pramlintide (AC137), delays gastric emptying in men with IDDM","volume":"38","author":"Macdonald, I.; Kong, King P.; M.-F.","year":"1995","unstructured":"Macdonald I, King P. Kong M-F, et al. Infusion of the human amylin analogue, pramlintide (AC137), delays gastric emptying in men with IDDM. Diabetologia 1995; 38 (suppl 1): A32.","journal-title":"Diabetologia"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.2337\/diacare.18.8.1179","article-title":"Reduction of postprandial hyperglycemia in subjects with IDDM by intravenous infusion of AC137, a human amylin analogue","volume":"18","author":"Kolterman, O.G.; Gottlieb, A.; Moyses, C.; Colburn, W.","year":"1995","unstructured":"Kolterman OG, Gottlieb A, Moyses C, Colburn W. Reduction of postprandial hyperglycemia in subjects with IDDM by intravenous infusion of AC137, a human amylin analogue. Diabetes Care 1995; 18: 1179-82.","journal-title":"Diabetes Care"},{"key":"ref_36","first-page":"193","article-title":"Reduction of postprandial hyperglycaemia in patients with type II diabetes by the human amylin analogue pramlintide (AC137)","volume":"38","author":"Kolterman, O.G.; Gottlieb, A.B.; Organ, K.A.; Thompson, R.G.","year":"1995","unstructured":"Kolterman OG, Gottlieb AB, Organ KA, Thompson RG. Reduction of postprandial hyperglycaemia in patients with type II diabetes by the human amylin analogue pramlintide (AC137). 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