Noninsulin Glucose-Lowering Therapy-The Ominous Octet Infographic

The Ominous Octet Infographic

Pdf Summary

The infographic, "Addressing the Ominous Octet," derives its insights from the American Diabetes Association's (ADA) "Standards of Medical Care in Diabetes—2024." It provides an overview of glucose-lowering medications for type 2 diabetes, highlighting the mechanisms responsible for elevated blood glucose levels, often referred to as the "ominous octet." This conceptual framework was first introduced by Ralph A. DeFronzo, building on his earlier work transitioning from the "triumvirate" model, which primarily implicated three factors, to the more comprehensive "ominous octet."<br /><br />The medications discussed, including Metformin, SGLT2 inhibitors, GLP-1 and GIP/GLP-1 receptor agonists, DPP-4 inhibitors, thiazolidinediones, and sulfonylureas, each target different pathophysiologic defects inherent in type 2 diabetes. These defects include:<br /><br />1. Impaired incretin effect, which can be addressed by medications like DPP-4 inhibitors and GLP-1 receptor agonists.<br />2. Impaired peripheral glucose uptake, contributing to insulin resistance.<br />3. Neurotransmitter dysfunction linked to appetite and mood regulation.<br />4. Increased renal glucose reabsorption, targeted by SGLT2 inhibitors.<br />5. Increased hepatic glucose output, which can be moderated by metformin.<br />6. Increased glucagon secretion, aggravated by inappropriate pancreatic function.<br />7. Defective insulin secretion, a primary concern in many diabetes treatments.<br />8. Increased lipolysis and insulin resistance, factors in weight management and metabolic control.<br /><br />By targeting these specific issues, the listed medications help manage glucose levels more effectively, offering a tailored approach to treatment. The ADA’s guidelines aim to inform clinicians about effective pharmacologic strategies, based on contemporary research and practice updates, facilitated by support from the Helmsley Charitable Trust and Abbott Diabetes Care, Inc. For more information, individuals can visit diabetes.org or contact the ADA directly.

Keywords

Ominous Octet

Type 2 Diabetes

Glucose-lowering Medications

American Diabetes Association

Metformin

SGLT2 Inhibitors

GLP-1 Receptor Agonists

DPP-4 Inhibitors

Insulin Resistance

Ralph A. DeFronzo