Pharmacological interventions for preventing or delaying onset of type 2 diabetes mellitus

Abstract

Prevention or delay of onset of type 2 diabetes in individuals at varying risk across the dysglycaemia continuum before overt diabetes becomes clinically manifest constitutes a leading objective of global disease prevention schemes. Pharmacological intervention has been suggested as a means to help prevent diabetes and reduce the global burden of this chronic condition. However, there is no credible evidence that early pharmacological intervention leads to long-term benefit in reducing diabetes-related complications or preventing early mortality, compared to treating people with diagnosed diabetes who have crossed the glycaemic threshold. In this review, we examine published evidence from trials using pharmacological agents to delay or prevent progression to diabetes. We also explore the benefit/risk impact of such therapies, safety issues and relevant off-target effects. Current evidence suggests none of the drugs currently available sustainably lower cumulative diabetes incidence, none provides a durable delay in diabetes diagnosis and none provides a convincing concomitant excess benefit for microvascular or macrovascular risk.

Renoprotective effect of berberine via regulating the PGE2‐EP1‐Gαq‐Ca2+ signalling pathway in glomerular mesangial cells of diabetic rats

“…The data presented here support the concept that EP1 may be an important therapeutic target for DN treatment and other kidney diseases related to the PGE 2 -EP1 signalling pathway. The importance of BBR in treating DN leads us to pursue a more detailed analysis, while a better understanding of the mechanisms and physicochemical properties will provide sufficient theoretical support for us to seek the possible therapeutic targets and promote the clinical application of BBR in DN [31]. However, to date, there is no report detailing the effects of BBR on diabetic patients, indicating the enormous potential application in treating diabetic kidney disease in patients.…”

Targeting metabolic disorders by natural products

“…Their major adverse effect is poor gastrointestinal tolerance. Although they reduce the NF-κB activity, their antioxidant and anti-inflammatory effects are not yet completely approved [ 40 ].…”

“…Its consumption is associated with increase in the risk of genital mycotic infections, urinary frequency, elevation of blood urea nitrogen and creatinine, diarrhea and fatigue [ 54 ]. Other drugs that could be considered in this section are Allopurinol, Pentoxifylline, Orlistat, anti platelet drugs (Aspirin, Clopidogrel), L-arginine, phosphodiesterase inhibitors (such as Theophylline), and pentaerythritol tetranitrate [ 7 , 40 , 55 – 57 ].…”

Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease

“…Available approaches that have demonstrated efficacy in patients with prediabetes or obesity include thiazolidinediones, metformin, acarbose, valsartan, basal insulin, orlistat, lorcaserin, intensive lifestyle modification, and bariatric surgery (7)(8)(9)(10). Compared with placebo or usual care, these approaches have been associated with a 15-85% reduction in the risk of incident diabetes.…”