Pharmacological management of type 2 diabetes mellitus: an update.

While lifestyle modifications and metformin are the cornerstone of the initial management of type 2 diabetes mellitus, there is an increasing array of second and third-line pharmacological agents for this condition. These include sulphonylureas, insulin, thiazolidinediones and alpha-glucosidase inhibitors, with the more recent addition of glucagon- like peptide-1 agonists, dipeptidyl peptidase-IV inhibitors and pramlintide. Moreover, insulin analogues that better simulate endogenous insulin secretion have been developed. This review aims to provide an update on the current pharmacological management of type 2 diabetes mellitus, and to highlight the benefits and limitations of each treatment.