Advances in Pharmacotherapeutics, Metabolic Surgery, and Technology for Diabetes

Endocrinol Metab Clin North Am. 2021 Sep;50(3):457-474. doi: 10.1016/j.ecl.2021.05.009.

Abstract

Remarkable advances in diabetes management have occurred since the discovery of insulin 100 years ago. Advances across a therapeutic spectrum, including pharmacotherapy, metabolic surgery, and diabetes technology, offer superior treatment options for diabetes management. New medication classes (glucagon-like peptide-1 receptor analogs and SGLT-2 inhibitors) have demonstrated cardiorenal benefits beyond glycemic control in type 2 diabetes mellitus, while evolving metabolic surgical interventions also help patients achieve diabetes remission. The use of artificial pancreas systems has shown consistent improvement in glycemic control in type 1 diabetes mellitus. It is time for policy changes to expand access to such advantageous therapies.

Keywords: CGM; Diabetes; Diabetes technology; GLP-1; Metabolic surgery; Obesity; SGLT-2 inhibitors.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Bariatric Surgery*
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / surgery
  • Glucagon-Like Peptide-1 Receptor / therapeutic use
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Sodium-Glucose Transporter 2 Inhibitors* / adverse effects
  • Technology

Substances

  • Glucagon-Like Peptide-1 Receptor
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors