Novel Agents for the Treatment of Type 2 Diabetes

Abstract

In Brief Impaired insulin secretion, increased hepatic glucose production, and decreased peripheral glucose utilization are the core defects responsible for the development and progression of type 2 diabetes. However, the pathophysiology of this disease also includes adipocyte insulin resistance (increased lipolysis), reduced incretin secretion/sensitivity, increased glucagon secretion, enhanced renal glucose reabsorption, and brain insulin resistance/neurotransmitter dysfunction. Although current diabetes management focuses on lowering blood glucose, the goal of therapy should be to delay disease progression and eventual treatment failure. Recent innovative treatment approaches target the multiple pathophysiological defects present in type 2 diabetes. Optimal management should include early initiation of combination therapy using multiple drugs with different mechanisms of action. This review examines novel therapeutic options that hold particular promise.

Periodontitis and Diabetes Mellitus: A Complex Relationship

“…Type 2 diabetes may remain undetected for many years and exhibit insulin resistance and other pathophysiologic abnormalities contributing to hyperglycemia referred to as the "ominous octet" shown in Fig. 3.1 [ 8 ]. In both type 1 and 2 diabetes, chronic hyperglycemia results in similar long-term complications.…”

Relation between diabetes mellitus, thyroid hormones and caffeine

“…It has been reported that caffeine may stimulate insulin secretion trough β pancreatic cells, due to the rise of intracellular Ca ++ (Park et al, 2009). In the skeletal muscle, insulin bind to its receptor causing the phosphorylation of the tyrosine of the receptor, resulting in insulin receptor substrates (IRS-1 and 2), IRS1 and 2 mediate the effects of insulin over glucose metabolism, through the activation of phosphatidylinositol (PI)-3 kinase and PKA/AKt and by the increase of GLUT4 and glycogen synthase (GS) (Defronzo, 2010). However, once the insulin receptor is not operating with its hormone, an insulin resistance occurs and the metabolism of glucose does not occur .…”

Sapium ellipticum (Hochst) Pax ethanol leaf extract modulates glucokinase and glucose-6–phosphatase activities in streptozotocin induced diabetic rats

“…Fasting hyperglycaemia in all forms of diabetes mellitus occurs primarily as a result of upsurge in hepatic glucose synthesis (HGS) [1,2]. Two specific enzymes, glucokinase (GK) and glucose-6 phosphatase (Glu-6-Pase) play crucial role in hepatic glucose production, utilization and homeostasis [3][4][5][6][7].…”