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Bromocriptine mesylate QR in trwatment of Type 2 diabetes

George Grunberger

There is a worldwide epidemic of Type 2 diabetes mellitus and practitioners everywhere are seeking optimal ways of approaching this complex and serious disease. Optimizing glycemic control to prevent long-term diabetic complications has been the holy grail of diabetes management. Bromocriptine mesylate QR is a sympatholytic dopamine D2 receptor agonist approved in the US for treatment of hyperglycemia in patients with Type 2 diabetes. It possesses a unique mode of action, acting centrally to enhance insulin sensitivity by resetting the circadian clock. In clinical trials it demonstrated lowering of A1c without the risks of hypoglycemia and weight gain. In addition, a possibility of cardiovascular benefit was raised in a large safety study. The major limitation of its use is the relatively high initial incidence of gastrointestinal events (nausea up to 30% and vomiting 8%). Among other adverse events, dizziness and headache were observed more commonly than in placebo- treated patients.