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      Bromocriptine--unique formulation of a dopamine agonist for the treatment of type 2 diabetes.

      Expert Opinion on Pharmacotherapy

      Blood Glucose, analysis, Bromocriptine, therapeutic use, Chemistry, Pharmaceutical, Diabetes Mellitus, Type 2, blood, drug therapy, economics, Dopamine Agonists, Humans, Hypoglycemia, Hypoglycemic Agents, Postprandial Period, Quality of Life, Randomized Controlled Trials as Topic, Treatment Outcome, Weight Gain

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          There is a large unmet need for new therapies to treat type 2 diabetes (T2DM) which reduce fasting and postprandial glucose without increasing insulin levels and which are not associated with weight gain or hypoglycemia. The quick-release formulation of bromocriptine (bromocriptine-QR; Cycloset) represents such a therapy. Bromocriptine-QR's proposed mechanism of action, unique formulation and clinical efficacy and safety will be discussed. A Medline search was conducted using the terms: bromocriptine quick-release, circadian rhythms, treatment type 2 diabetes, insulin resistance, beta-cell dysfunction (years 1985 - 2009). The reader will gain an understanding of the importance of the brain as a target for the treatment of type 2 diabetes. In addition the safety, efficacy and indication for use of a first-in-class dopamine agonist as a treatment option for type 2 diabetes are discussed. Bromocriptine-QR is indicated to be used alone or in conjunction with all available treatments for type 2 diabetes. Although the mechanism of action is not fully understood, bromocriptine-QR's action points to a central target in the brain (hypothalamus) which may explain the observed peripheral improvements in metabolic parameters.

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