origins of type 2 diabetes medications

The origins of diabetes medications provide an intriguing catalogue clinical serendipity and scientific design. Use insulin (beyond 1922) gave recognition to resistance the categorisation type 2 (T2DM). first sulphonylurea (carbutamide, 1956) emerged from its use as antibacterial sulphonamide prone cause hypoglycaemia, biguanides were used treat in 1957 despite their glucose-lowering properties having been known since 1920s. Alpha-glucosidase inhibitors arose a screening programme for amylase by Bayer 1970s acarbose was introduced 1990. thiazolidinedione (ciglitazone; not developed) identified triglyceride-lowering compounds Takeda late rise pioglitazone (approved 1999), although market troglitazone (from Warner Lambert 1997, withdrawn 2000). Exendin, analogue incretin hormone glucagon-like peptide-1 (GLP-1), 1992 saliva lizard (Heloderma suspectum), took until 2005 be marketed exenatide. To promote efficacy endogenous GLP-1, rapid inactivation enzyme dipeptidylpeptidase-4 (DPP4) blocked clever molecular design DPP4 (vildagliptin sitagliptin, approved 2006). SGLT2 are based on phlorizin, apple tree bark (1835) modified (2000) avoid intestinal degradation: further modifications increase selectivity against dapagliflozin canagliflozin - 2012 2013, respectively, Europe.