Incretin-based therapies and their future in Type 2 diabetes mellitus

Travis E Sonnett, Jennifer D Robinson and Kurt A Bowen

Several incretin therapies have been approved by the US FDA and/or the European Union for treatment of Type 2 diabetes mellitus (T2DM), either as monotherapy or in conjunction with diet, exercise and other T2DM therapies. Incretin-based therapies, specifically glucagon-like peptide-1 agonists, have been reported to offer a unique mechanism to lower hemoglobin A1c levels by 0.4–1.1%, as demonstrated in clinical trials, and as a secondary effect reduce weight by 1–4 kg. Dipeptidyl peptidase-4 inhibitors also offer a new mechanism to reduce hemoglobin A1c levels by 0.3–1.9%, as seen in clinical trials; weight loss, however, has been reported as variable. Given the projected increase in obesity and diabetes, as well as the growing evidence linking obesity and development of T2DM, incretin-based therapies may offer a future first-line agent to fight both rising sugars and rising weight.