New substances in the oral treatment of diabetes mellitus type 2 [Neue substanzen in der oralen medikation des diabetes mellitus typ 2]

Two new classes of orally active compounds were developed recently. Rimonabant is the first endocannabinoid-1-receptor antagonist to be approved. It improves the parameters of lipid metabolism and HbA1c by paracrine and endocrine effects on adipose tissue, muscle, brain, and liver, and lowers body weight. Second, dipeptidyl-peptidase IV (DPP-4) inhibitors are about to be introduced. They inhibit the degradation of regulatory peptides involved in stimulating insulin secretion, mainly glucagon-like peptide-1 and gastric inhibitory polypeptide. Both hormones are secreted postprandially and contribute to 50-70% of the stimulation of insulin secretion after a meal. DPP-4 inhibitors themselves do not cause hypoglycemia and have further favorable effects in type 2 diabetes therapy, inhibiting glucagon secretion and improving beta cell function. © 2006 Springer Medizin Verlag.