Treatment of type 2 diabetes – what’s new? Analogue insulins, and what else?

Until the 1990s, the pharmacological treatment of type 2 diabetes was limited to three drugs: insulin, metformin, and sulfonylurea. We now have many modern drugs that greatly facilitate good metabolic alignment of type 2 diabetes. The mechanism of the development of this type of diabetes is complex. Many factors lead to the development of insulin resistance, which is a major disorder leading to the development of type 2 diabetes. Hence, treatment for type 2 diabetes must be undertaken to reduce insulin resistance. This allows the protection of -cell functions. First of all, it is necessary to use dietary treatment and to increase physical activity. If this does not give sufficient glycaemic control then pharmacotherapy is required. Among modern antidiabetic drugs, incretin drugs are particularly noteworthy, including GLP-1 analogues, DPP-4 inhibitors, and SGLT2-inhibitors.

These medicines can be used alone or in combination with other medicines, including insulin. Implementation of insulin therapy in patients with type 2 diabetes should include careful consideration of indications – evaluation of β-cell function, as well as contraindications – the risk of hypoglycaemia and weight gain. For indications for insulin therapy, analogue insulin is most commonly used today.