Review of medications used in the treatment of diabetes mellitus

Objective: To review the pathophysiology of diabetes mellitus and outline currently available medications used in its treatment. Data Sources: A MEDLINE/PubMed search (1966-December 2009) was conducted for English-language articles using the terms diabetes mellitus, pharmacotherapy, metformin, thiazolidinedione, sulfonylurea, meglitinide, α-glucosidase inhibitor, DPP-4 inhibitor, colesevelam, bromocriptine, exenatide, pramlintide, and insulin. Book chapters relevant to the pathophysiology and pharmacologic treatment of diabetes were also searched. Study Selection and Data Extraction: Articles and chapters pertinent to the pharmacologic management of diabetes mellitus were reviewed. Data Synthesis: Type 1 diabetes is characterized by an absolute lack of insulin production by the β-cells of the pancreas, requiring insulin therapy. Type 2 diabetes is characterized by both insulin resistance and a relative or absolute lack of insulin secretion. Because type 2 diabetes involves both insulin resistance and decreased insulin production over time, people with type 2 diabetes can be treated with a variety of drugs currently on the market. Therapies currently on the market include metformin, thiazolidinediones, sulfonylureas, meglitinides, α-glucosidase inhibitors, DPP-4 inhibitors, colesevelam, bromocriptine, exenatide, pramlintide, and insulin. Conclusions: Given the multitude of medications available for the treatment of diabetes, it is important that pharmacy technicians and pharmacists be aware of the various agents currently on the market. With a solid foundation of knowledge regarding diabetes medications, a huge impact can be made on the quality of care of the customers and patients the pharmacy serves.