Type 2 Diabetes: An Expanded View of Pathophysiology and Therapy

Abstract

Type 2 diabetes mellitus is a complicated metabolic disease affecting millions of individuals worldwide. The medications used to manage the disease are based on different pharmacologic approaches, including decreasing hepatic gluconeogenesis, stimulating pancreatic insulin production, slowing polysaccharide digestion, and increasing insulin sensitivity in muscle, liver, and fat to lower blood glucose. Incretin-based therapies, including glucagon-like peptide-1 (GLP-1) receptor agonists, mimic the effects of native GLP-1, while dipeptidyl peptidase-4 inhibitors increase circulating concentrations of endogenous GLP-1. This review focuses on means by which primary care physicians might evaluate the utility of pharmacologic agents based on their relation to the pathogenesis of type 2 diabetes. In general, patients with type 2 diabetes should be treated to their lowest targeted glycemic goals as soon as they are diagnosed, for as long as possible, as safely as possible, and as rationally as possible.

Controversies surrounding the clinical potential of cinnamon for the management of diabetes

“…Research into the health benefits of cinnamon has focused mostly on its potential to treat or prevent insulin resistance, metabolic syndrome and T2D [17][18][19]. T2D is a complex metabolic disorder of impaired insulin sensitivity (insulin resistance) of peripheral tissue such as skeletal muscle and impaired insulin secretion [20,21]. The exact mechanism of insulin resistance is poorly understood, but involves defects in the insulin signalling pathway, such as impaired activation of phosphatidylinositol 3-kinase (PI3K) and downstream signalling [22].…”

Angiotensin II type 1 receptor antagonists in the treatment of hypertension in elderly patients: focus on patient outcomes

“…Diabetes is rapidly increasing worldwide in all patient groups, including the elderly 73. It is estimated that 50% of patients with diabetes suffer from hypertension, and this number is even higher in the elderly 74.…”

The changes of cholecystokinin and cannabinoid 1 peptide receptor in stomach and duodenum of Type 2 diabetic rats treated with dipeptidyl peptidase-4 inhibitor-sitagliptin.

“…Dünyadaki diyabet vakalarinin %90'indan fazlasini oluşturan Tip 2 Diabetes Mellitus (T2DM), bozulmuş insülin direnci veya bozulmuş insülin sekresyonu sonucunda ortaya çikan metabolik bir hastaliktir [3,4]. T2DM insülin duyarliliğinda azalma, kaslarda ve karaciğerde insülin direnci, pankreas β hücrelerinde fonksiyon bozukluğu ve yağ dokusunda artiş gibi metabolik anormalliklerle tanimlanir [5,6]. T2DM oluşma riskinin yaş, obezite ve fiziksel aktivite eksikliği ile arttiği bilinmektedir.…”