The rising prevalence of diabetes mellitus worldwide will provide significant challenges to global health in the future. Today the healthcare professional managing diabetes has a very wide variety of pharmacological options to choose from and the number of drugs that have been developed to combat this disorder is rising. Numerous studies have shown that early treatment of diabetes is associated with better long-term outcomes. There is also an important need to individualize the treatment of each patient depending on his or her clinical presentation and other factors. The very large number of drug classes can, at times, be confusing and this can be an obstacle in selecting the right drug at the right stage of an individual’s disease. The aim of this review therefore is to outline all the drugs currently in use for the management of diabetes. The classes of drugs reviewed here include insulin, GLP-1 agonists, biguanides, sulphonylureas, glinides, thiazolidinediones, gliptins, α-glucosidase inhibitors, amylin analogues and SGLT-2 inhibitors. Each class of drugs is reviewed and the mechanism of action, key trial data, side effects and long-term outcome studies are summarized. It is hoped that this review will aid the healthcare professional in choosing the most appropriate therapy for each individual patient, thereby helping to optimize the long-term management of this challenging disorder.
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