Antidiabétiques oraux dans le traitement du diabète de type 2 : perspectives historique et médico-économique

[fr] Le traitement oral du diabète de type 2 (DT2) s’est fortement diversifié au cours de la dernière décennie, avec la commercialisation d’abord des glitazones, puis des gliptines, et, enfin, tout récemment, des gliflozines. Pourtant, les deux antidiabétiques oraux développés il y a plus de 50 ans, la metformine et les sulfamides hypoglycémiants, restent les leaders du marché. Après la metformine, le choix des médicaments antidiabétiques est problématique, et doit se faire en fonction d’une évaluation de la balance bénéfices/risques, en intégrant le coût du traitement, et en favorisant une approche individuelle centrée sur le patient diabétique. Cette stratégie est celle recommandée dans la publication conjointe de l’American Diabetes Association (ADA) et de l’European Association for the Study of Diabetes (EASD), actualisée en janvier 2015. Si les grands principes du traitement du DT2 sont universels, des particularités doivent sans doute être discutées en fonction des situations régionales, et le continent Africain présente certainement des particularités à cet égard.
[en] Oral therapy of type 2 diabetes (T2D) is becoming increasingly complex during the last decade, with first the launch of glitazones, then that of gliptins and finally, very recently, that of gliflozins. However, the two oral glucose-lowering agents developed more than 50 years ago, metformin and sulfonylureas, still remain the leaders in the market. After failure of metformin monotherapy, the choice of antidiabetic medications is difficult and should be made taking into account the benefit-risk balance, with a special attention to cost of therapy and a focus on a patient-centered approach. This strategy is recommended in the recently updated joint ADA-EASD position statement, in January 2015. If the main principles of T2D therapy are universal, particularities should probably be discussed regarding regional situations, and the African continent obviously presents specificities in this respect.

Disciplines :

Endocrinology, metabolism & nutrition
Pharmacy, pharmacology & toxicology

Author, co-author :

SCHEEN, André ; Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques

Language :

French

Title :

Antidiabétiques oraux dans le traitement du diabète de type 2 : perspectives historique et médico-économique

Alternative titles :

[en] Oral antidiabetic agents in the treatment of type 2 diabetes: Historical, clinical, and economical perspectives

Publication date :

2015

Journal title :

Médecine des Maladies Métaboliques

ISSN :

1957-2557

eISSN :

2214-8477

Publisher :

Masson, Issy-les-Moulineaux, France

Volume :

Issue :

Pages :

186-197

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

http://www.elsevier-masson.fr/medecine-des-maladies-metaboliques-1957-2557.html

Available on ORBi :

since 31 March 2015

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