Overview of Current and Upcoming Strategies Implied for the Therapy of Type 2 Diabetes Mellitus

Abstract

Population explosion, urbanization, changes in lifestyle management, improper food habits and various other factors play focal contributors in the massive prevalence of type 2 diabetes mellitus in the developing countries. Although insulin is the cornerstone in the management of type 1 diabetes; insulin, anti-hyperglycemic and hypoglycemic agents are proved to be effective in type 2 diabetes, although their efficacy decreases with the progress of the disease. Moreover a significant number of side effects, mostly hypoglycemia and weight gain have put a bar in using these drugs confidently. Many novel therapeutic strategies with convincing efficacy and less adverse effects are currently emerging for providing efficient means of treatment of this disorder. This article mainly focuses on newer and unconventional pharmaceutical or biotechnical strategies that may or may not have been implied for the treatment of Type 2 Diabetes mellitus on a widescale basis so far. These strategies are supposed to be efficient in controlling glycemic levels and possess a significant potential to reduce the co-morbidities associated with this disease.

Efficacy and safety of sitagliptin compared with sulfonylurea therapy in patients with type 2 diabetes showing inadequately controlled glycosylated hemoglobin with metformin monotherapy: A meta-analysis

“…Despite lifestyle and pharmacological interventions, patients with type 2 diabetes mellitus continue to experience increases in glucose levels over time, which is likely to be as a consequence of declining β-cell function. One study found that approximately two-thirds of patients with type 2 diabetes mellitus in developed countries do not effectively control their glucose levels and that an even greater proportion does not do so in developing countries, particularly in China ( 2 ). A major reason for this failure is the progressive nature of type 2 diabetes mellitus, which makes it difficult for patients to maintain target levels of glycated hemoglobin (hemoglobin A1c; HbA1c) using traditional glucose-lowering agents, and usually requires them to take multiple antihyperglycemic agents (AHAs) to attain or maintain glycemic control.…”

Effects of different metabolic states and surgical models on glucose metabolism and secretion of ileal L‐cell peptides: results from the HIPER‐1 study

“…GLP-1 and PYY) play an important role in the regulation of glucose homeostasis [5,7,20,21]. Elucidating the mechanisms responsible for improvement in plasma glucose concentration after bariatric/metabolic surgery will help identify potential targets for diabetes therapy [14].…”

“…Furthermore, improving β‐cell function in people with type 2 diabetes improves glucose control; thus, therapies that improve β‐cell function (e.g. GLP‐1 receptor agonists and thiazolidinediones) produce durable reductions in HbA 1c in type 2 diabetes . Several studies have demonstrated marked improvement in β‐cell function in type 2 diabetes following gastric bypass , but no study has assessed the impact of ileal transposition and transit bipartition on β‐cell function in people with type 2 diabetes.…”

Type 2 Diabetes Mellitus;

“…3 A Study showed that control of T2DM is not up to the mark in the developed countries in about 2/3 rd of patients and this fact is even more pronounced in the developing countries. 4 In Pakistan, the prevalence T2DM is quite high and approximately 6.3 million people have this disease. This is likely to increase and by 2030 about 11.4 million peoples will have diabetes if appropriate measures are not taken.…”