New therapies for diabetes.

The role of hormones secreted by the gut in maintaining blood glucose homeostasis has recently been recognized. This recognition has led to the emergence of several novel classes of medications--the glucagon-like peptide-1 (GLP-1) agonists and the dipeptidyl peptidase (DPP)-IV inhibitors--that may target a key element of the underlying pathophysiology of type 2 diabetes mellitus (DM). Both GLP-1 agonists and DPP-IV inhibitors may have the ability to expand beta-cell mass. Because the demise of beta-cell mass and function is a critical element in the progression of type 2 DM, these agents may have the potential to reverse the natural history of type 2 DM. However, further studies are needed to confirm both long-term beta-cell preservation and the role of these agents in the management of diabetes.