Prevention of type 2 diabetes – new agents (#185)
“New” agents – DPP-4 inhibitors, GLP-1 analogues, SGLT-2 inhibitors and new insulins – all have theoretical potential to “prevent” diabetes. In this light prevention includes delay of onset and actual prevention. Mechanisms might include reduction in glucotoxicity, modification of b-cell function or modification of b-cell mass. For the varying classes of agent, some supporting preclinical evidence exists to support potential benefit of early introduction of therapy. To date, there is little clinical data to support use of these agents to prevent diabetes, not least because of difficulties with trial design and cost. Existing data and trials in progress will be discussed, as will concepts of patient selection and risk-benefit analyses.