This article provides an overview of the development of insulins, oral agents, and noninsulin injectable agents used in the management of hyperglycemia in patients with diabetes. It also briefly reviews the pharmacological impact and salient side effects of these medications. The management of diabetes has changed dramatically during the past several thousand years. The option preferred by “experts” of the pharaoh of Egypt 3,500 years ago was a mixture of “water from the bird pond,” elderberry, fibers from the asit plant, milk, beer, cucumber flower, and green dates. Although our therapeutic options today are significantly more effective, they will likely be considered arcane by our successors 100 years from now if the current trajectory in treatment development continues. Clearly, however, the current pharmacological armamentarium used to manage diabetes has resulted in a dramatic reduction in morbidity and mortality. This article provides a brief overview of the development history and effectiveness of various agents used in the pharmacological management of diabetes.
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