Diabetes mellitus - advances in treatment

Type 2 diabetes mellitus is a heterogeneous disease the management of which involves a number of therapeutic approaches including

various pharmacotherapies. Hypoglycaemia has repeatedly been shown to be the major barrier in achieving normoglycaemia. Thus,

the goal is to treat the patient with medications that will result in normalization of glycaemia without the risk of hypoglycaemia. Therefore,

it is very encouraging that the new pharmaceuticals to treat type 2 diabetes lead to a decrease in glycaemia with a minimal or

even no risk of hypoglycaemia. They are medications whose mechanism of action is based on affecting the incretin system. Incretins

are hormones produced by intestinal cells and result in increased secretion of insulin from the secretory granules of pancreatic betacells in increased glycaemia and in postprandial suppression of glucagon secretion. Some of them slow down stomach emptying and,

through their central effect, accelerate the sensation of saturation and reduce the feeling of hunger in the central nervous system. Their

secretion particularly rises postprandially and their reduced concentration was shown in type 2 diabetics. Last and this year, two groups

of medications whose mechanism of action is based on incretins were introduced into the clinical practice in the Czech Republic. They

are dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists.

Keywords: compensation of diabetes, prevention of hypoglycaemia, incretins