What Are Incretins, and How Will They Influence the Management of Type 2 Diabetes?

OBJECTIVES: To review the pathophysiology of type 2 diabetes (T2DM), the role ofincretins, the potential of incretin-based therapies to address unmet therapeuticneeds in T2DM, and the potential impact this will have on the contribution of managed care pharmacy to diabetes therapy. SUMMARY: Diabetes, the fifth leading cause of death by disease in the United States, costs approximately $132 billion per year in direct and indirect medical expenses. According to the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey, a majority of diabetes patients do not achieve target A1C levels with their current treatment regimens. Advances in understanding the pathophysiologic abnormalities underlying the metabolic dysfunctions associated with T2DM are leading to the development of new treatment approaches and new therapeutic classes of drugs. Novel incretin-based therapies currently available, andin late-stage development, are among those showing the greatest promise for addressing the unmet needs of traditional therapies.