Management of Type 2 Diabetes: Current Strategies, Unfocussed Aspects, Challenges, and Alternatives

Abstract

Type 2 diabetes mellitus (T2DM) accounts for >90% of the cases of diabetes in adults. Resistance to insulin action is the major cause that leads to chronic hyperglycemia in diabetic patients. T2DM is the consequence of activation of multiple pathways and factors involved in insulin resistance and β-cell dysfunction. Also, the etiology of T2DM involves the complex interplay between genetics and environmental factors. This interplay can be governed efficiently by lifestyle modifications to achieve better management of diabetes. The present review aims at discussing the major factors involved in the development of T2DM that remain unfocussed during the anti-diabetic therapy. The review also focuses on lifestyle modifications that are warranted for the successful management of T2DM. In addition, it attempts to explain flaws in current strategies to combat diabetes. The employability of phytoconstituents as multitargeting molecules and their potential use as effective therapeutic adjuvants to first line hypoglycemic agents to prevent side effects caused by the synthetic drugs are also discussed.

Weight‐reducing, lipid‐lowering and antidiabetic activities of a novel arginine vasopressin analogue acting at the V1a and V1b receptors in high‐fat‐fed mice

“…The last 15 years have witnessed a substantial increase in the treatment options available for type 2 diabetes with the timely introduction of glucagon‐like peptide‐1 (GLP‐1) mimetics, as well as dipeptidyl peptidase‐4 (DPP‐4) and sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors 1 . In particular, the clinical success of GLP‐1 mimetics has illustrated the benefit of simultaneous activation of multiple physiological pathways by a single peptide entity, conferring positive effects on insulin secretion and action, gut motility, appetite and body weight, as well as cardiovascular and neuronal function 2 .…”

Sargassum fusiformepolysaccharide is a potential auxiliary substance for metformin in the management of diabetes

“…2 Although many drugs have been applied in DM treatment, most of them have side effects like ketoacidosis, hypoglycemia, gastrointestinal reactions and heart failure. 3…”

Effect of kolaviron on islet dynamics in diabetic rats

“…These drugs are also under investigation as adjunctive to insulin therapies for T1D patients ( Bacha and Klinepeter Bartz, 2016 ). Although these drugs have demonstrated benefits in diabetes management, a robust, sustained glycemic control over time has not been achieved and, some associated adverse effects remain unresolved ( Borse et al, 2021 ). Also, non-adherence to the insulin treatment regimen ( Doggrell and Chan, 2015 ), risk of hypoglycemia, low insulin availability and affordability ( Li et al, 2019 ), failure of insulin to achieve glycemic targets ( Cohen et al, 2016 , Harris et al, 2017 ), and recent findings of insulin resistance following intensive insulin treatment ( Okamoto et al, 2011 , Karras et al, 2019 ) limits the benefits of intensive insulin therapy.…”

“…Therefore, α-cells are also potential targets in diabetes ( Marroqui et al, Jun 2014 , Gaisano et al, 2012 ). Several natural compounds, including those derived from plants, have received research attention as potential adjuvant or as alternative agents for diabetes management ( Yonamine et al, 2016 , Shirpoor, 2017 , Borse et al, 2021 ). Some natural compounds and herbs exert regenerating and protective effects on β-cells, thus improving β-cell function and glycemic control.…”