Diabetes of the Exocrine Pancreas: Implications for Pharmacological Management

Post-pancreatitis diabetes mellitus, pancreatic cancer-related diabetes, and cystic fibrosis-related diabetes are often underappreciated. As a result, a substantial proportion of people with these sub-types of diabetes receive antidiabetic medications that may be suboptimal, if not harmful, in the c...

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Bibliographic Details
Published in:Drugs (New York, N.Y.) N.Y.), 2023-08, Vol.83 (12), p.1077-1090
Main Authors: Goodarzi, Mark O., Petrov, Maxim S.
Format: Article
Language:English
Subjects:
Agonists
Amylin
Antidiabetics
Cancer therapies
Chemotherapy
Clinical trials
Cohort analysis
Cystic fibrosis
Diabetes
Diabetes mellitus
Disease
Dopamine D2 receptors
Drug therapy
GIP protein
GLP-1 receptor agonists
Glucagon
Glucagon-like peptide 1
Glucose
Glucose transporter
Glucosidase
Hyperglycemia
Hypoglycemia
Inhibitors
Insulin
Insulin resistance
Internal Medicine
Leading
Leading Article
Lipids
Medicine
Medicine & Public Health
Meta-analysis
Pancreas
Pancreatic cancer
Pancreatitis
Patients
Peptides
Pharmacology/Toxicology
Pharmacotherapy
Polypeptides
Receptors
Systematic review
Thiazolidinediones
α-Glucosidase
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Summary:Post-pancreatitis diabetes mellitus, pancreatic cancer-related diabetes, and cystic fibrosis-related diabetes are often underappreciated. As a result, a substantial proportion of people with these sub-types of diabetes receive antidiabetic medications that may be suboptimal, if not harmful, in the context of their underlying disease of the exocrine pancreas. The present article delineates both classical (biguanides, insulin, sulfonylureas, α-glucosidase inhibitors, thiazolidinediones, and meglitinides) and newer (glucagon-like peptide-1 receptor agonists, amylin analogs, dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter-2 inhibitors, D2 receptor agonists, bile acid sequestrants, and dual glucagon-like peptide-1 receptor and glucose-dependent insulinotropic polypeptide receptor co-agonists) therapies and provides recommendations for managing people with diabetes of the exocrine pancreas based on the most up-to-date clinical evidence. Also, several emerging directions (lipid-enriched pathways, Y4 receptor agonism, glucagon-like peptide-1 and glucagon receptor co-agonism) are presented with a view to informing the process of new drug discovery and development.
ISSN:0012-6667
1179-1950
DOI:10.1007/s40265-023-01913-5