The number of patients suffering from diabetes mellitus (DM), which is a chronic metabolic disorder and mainly classified as either insulin-dependent type 1 or non-insulin-dependent type 2, is increasing throughout the world. The sequence of DM progression makes this disease a major health risk in regard to microvascular disease that leads to kidney failure, blindness, and nerve damage as well as macrovascular disease that leads to amputations, cardiovascular disease, and stroke. To treat DM, several types of insulin preparations and synthetic drugs for type 1 and type 2 DM, respectively, are in clinical use. However, there are several problems concerning the insulin preparations and synthetic drugs, such as physical and mental pain due to daily insulin injections and defects involving several side effects, respectively. Thus, the disease demands extraordinary effects to define pathobiochemical pathways and strategies for prevention and to find new therapeutic approaches. For this purpose, oxovanadium(IV) (vanadyl, VO 2þ ) and zinc(II) containing complexes have been explored as treatments for both types of DM. This article reviews the current state of research on insulin-mimetic and antidiabetic metal complexes, with special focus on paramagnetic vanadyl and diamagnetic zinc(II) complexes with different coordination modes, together with possible reaction mechanisms. New drug delivery systems involving enteric-coated capsulation and a biopolymer are also reviewed.One of the most important findings in the 20th century was that metal ions and their biomolecular complexes are essential for life on the earth and play roles in not only metalloproteins and metalloenzymes but also gene expression.1,2 This fundamental knowledge showed that our health, aging, physiological disorders and diseases are related to the state of the metal ions and their biomolecular complexes in our body. Some clinically useful metal-containing compounds and metal complexes known as metallopharmaceuticals that can regulate human health have been developed to treat or cure many types of diseases. The most distinctive examples are the platinum (Pt) anti-tumor agents, cisplatin and related newly developed Pt complexes, the gold (Au) orally active anti-rheumatoidal agent auronofin, the aluminum (Al) and zinc (Zn) anti-ulcer agents scralfate and polaprezinc, respectively, the selenium (Se) antiinflammatory agent ebselen, and the lithium (Li) anti-manicdepressive agent lithium carbonate.