Century of Evolution of Non-Insulin Therapeutic Options in Management of Diabetes

First recognized by the ancient Egyptians, the presentation and treatment of diabetes have dramatically evolved over the centuries [1]. Though the discovery of insulin 100 years ago changed the management of diabetes forever, most patients today are not insulin deficient, but overweight with a combination of insulin resistance and impaired insulin secretion [1]. While lifestyle changes can be very effective in improving glucose control, in the long-term most patients will eventually require medications to achieve adequate diabetic control [2]. For decades options for oral glucose lowering medications were limited, but in the past 25 years many more options have become available. The purpose of this article is to provide an overview of the existing oral and injectable (non-insulin) pharmacologic options available for the treatment of patients with type 2 diabetes.