Clinical Review of Antidiabetic Drugs: Implications for Type 2 Diabetes Mellitus Management

Type 2 diabetes mellitus (T2DM) is a worldwide pandemic, as can be seen from the world cartographic map of diabetes by the International Diabetes Federation. Diabetes mellitus is a chronic, progressive, partially unravelled metabolic disease predominantly defined by hyperglycaemia. Impaired secretion of insulin, tissue resistance to the action of insulin, or both are the most prevalent underlying causes of the pathophysiology of T2DM, a disease spectrum that was initially due to tissue insulin resistance and eventually evolving towards a condition with total loss of secretory function of the beta cells of the pancreas. T2DM is a principal cause of the extremely high increase in the incidence of non- communicable diseases in both developed and developing countries. We attempt to define in this mini review the present management concepts, from the range of medicines prescribed now for the drug management, to reduce raised blood glucose in T2DM. Type 2 diabetes mellitus (T2DM) is a growing, worldwide health burden closely associated with the obesity epidemic.Patients withT2DM are at particularly high risk for bothmicrovascular(such as retinopathy, nephropathy and neuropathy) and microvascular complications (such as cardiovascular comorbidities) due to hyperglycaemia and individual constituents of the insulin resistance (metabolic) syndrome. Environmental conditions (e.g., obesity, poor diet and physical inactivity) and genetics are responsible for the various pathophysiological disruptions that underlie compromised glucose homeostasis in T2DM. The pathogenic role of inflammation in type 1 and type 2 diabetes is discussed, as well as the mediators and anti-inflammatory therapies. In addition, the role of different organs in diabetes mellitusis emphasized,including the adipose tissue and obesity, gut microbiota, and pancreatic-cells. The expression of pancreatic Langerhans -cell islet inflammation, oxidative stress, and defective insulin production and secretion are discussed.