The most recent studies indicate that 14 percent of Spaniards over 18 have a type 2 diabetes mellitus (DM2) and that in half of the cases have not been diagnosed.

Although metformin continues to be the first choice drug for adult treatment, in the last ten years other solutions that are effective in decreasing glycemia levels have been marketed, but which go further and promote other benefits for the patient.The reduction of cardiovascular morbidity and mortality and better metabolic control are the most prominent.

José Javier Mediavilla, family doctor and member of the Diabetes Group of the Spanish Society of Primary Care Physicians (Semergen), has reviewed the new drug families for DM2 in the 21 Pharmaceutical National Congress, which, in addition to addressing professional issues ofMaximum actuality, he did not want to put aside some of the most prevalent pathologies, such as diabetes.

"They do not produce hypoglycemia and not only lower glycemia but also provide more benefits," says the expert.

"The new drugs are safe and contribute other benefits"

Peptidase 4 dipeptidyl inhibitors are characterized by stimulating the increase in peptide concentration similar to type 1 LPG-1 glucagon and insulin secretion in the beta cell of the pancreatic islet.They are very safe drugs and can be used in situations of renal insufficiency: "They have very few side effects and are very prescribed in primary care such as second step drugs, mainly for the elderly."

Sodium and glucose cotransporter inhibitors type 2 (SGL T2) reduce renal glucose reabsorption and increase their urinary elimination, decreasing glucose concentrations.And the agonists of the LPG-1 receiver are a type of medication with incredine action.These medications (exanatida, liraglutida, lixisenatida, dyaglutida, semaglutida, albiglutida) copy or imitate the action of the LPG-1 produced by the body.

for compliance

Various agonists of the short, long and prolonged LPG-1 receiver have been developed with structural, pharmacodynamic and clinical differences that can be administered in different therapeutic combinations, allowing to individualize the treatment.They are injectable and can even be administered weekly, which facilitates therapeutic compliance.

"Some of the drugs of these last two families decrease cardiovascular morbidity and mortality in cardiopathic or high risk patients," he explains to CF Mediavilla.They also favor weight loss, four and more kilos, which is beneficial for patients with diabetes and overweight.They also lower blood pressure, which results in a better metabolic control.

These two groups also have adverse effects.In the case of sodium and glucose cotransporter inhibitors type 2, the main problem is genitourinary infections, especially genital picmous.Nausea and vomiting are the possible complications of the agonists of the GP-1 receiver.

"The pharmacy is key to monitoring and strengthening compliance"

The endocrine are the professionals who most prescribed these drugs, but each time it is done more in the first level of care: “They are more replaced to older medications that cause hypoglycemia and do not have these benefits, always respecting the metformin, which remains thetreatment base ”.

in pharmacies

Diabetes is an integral disease, which merits attention from different care levels and by all health professionals.

In this context, the role of the pharmacist of the Community Pharmacy is essential together with the one they performThe other health professionals, as Mediavilla underlines: “Its role is very important to monitor and strengthen compliance with the treatment.

Also to advise on hygienic-dietary measures and on side effects. ”