New Hypoglycaemic Drugs for the Treatment of Diabetes Mellitus and Its Complications: The Future is coming

Diabetes mellitus (DM) has become a growing epidemic over the last few decades. The International Diabetes Federation (IDF) estimates that more than 640 million people will be affected by this condition by 2040. Although the incidence of some of the cardio-vascular complications of DM seems to have shown a decrease over the last years, DM continues to be the main cause of kidney disease, which will require renal replacement therapy (RRT). Many different studies have tried to demonstrate, not always effectively, that the application of clinical practice guidelines and consensus documents may help to stop the onset and progression of the vascular and renal complications of DM. Numerous molecules have also emerged in recent years to improve both the management of DM as well as the onset of micro and macro vascular complications. In this review, we will provide a summary of the metabolic, vascular and renal effects of DPP-4 inhibitors, Glucagon-likePeptide 1 Receptor agonists (GLP-1a) and sodium-glucose co-transporter inhibitors (SGLT2i), especially in patients with diabetic kidney disease with decreased renal function. These new molecules seem to open favorable perspectives in the integrated and multi factorial care of the DM patients.