Table 7.
In the Pipeline: Selected Emerging Antihyperglycemic Compounds
| Drug category | Mechanism of action | Comments |
|---|---|---|
| Glucokinase activators | Activate key enzymes to increase hepatic glucose metabolism | Several drugs are currently in phase 2 clinical trials |
| Sodium-glucose cotransporter 2 inhibitors | Inhibit reabsorption of glucose at the proximal tubule of the kidney, thereby decreasing systemic hyperglycemia | Low potential for hypoglycemia |
| 11β-hydroxysteroid dehydrogenase 1 (11β-HSD 1) inhibitors | Inhibit an enzyme responsible for activating cortisone to cortisol, thus minimizing antiglycemic effects of cortisol | Low potential for hypoglycemia, may have beneficial effects on metabolic syndrome |
| Glucagon receptor antagonists | Block glucagon from binding to hepatic receptors, thereby decreasing gluconeogenesis | Low potential for hypoglycemia |
| Cannabinoid-1 (CB-1) receptor antagonists | Block CB-1 receptors systemically | Marketed as an obesity drug, may cause psychiatric symptoms |
Source: Inzucchi SE, McGuire DK. New drugs for the treatment of diabetes mellitus: part II: incretin-based therapy and beyond. Circulation. 2008;117:574–584.