Pharmacological therapies for type 2 diabetes: future approaches – Published online 31/10/2025

Clifford J. Bailey

Optimising the control of blood glucose is fundamental to the management of type 2 diabetes; however, the varied and progressive pathophysiology of type 2 diabetes plus the limitations of current medicines leave many unmet needs. In this issue, Clifford Bailey (https://doi.org/10.1007/s00125-025-06581-6) highlights non-insulin candidates that aim to exploit new mechanisms or enhance existing approaches to improve glucose metabolism, assist weight control and reduce the risk of cardiorenal and other comorbidities. Novel agents advancing in development include multi-agonist incretin- and amylin-based peptides that reduce appetite, and small molecules that target mitochondria and promote energy expenditure. Agents aiming to preserve or regenerate pancreatic beta cells by manipulating transcription or translation are also under investigation, as well as antibodies to sustain muscle mass while reducing adiposity. The author concludes that, although delivery of agents to specific cell types and tissues remains a challenge, emerging studies herald exciting prospects for precision medicine. The figure from this review is available as a downloadable slide.

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