Meneses Maria J, Silva Branca M, Sousa Mário, Sá Rosália, Oliveira Pedro F, Alves Marco G
CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Av. Infante D. Henrique, 6201-506 Covilhã, Portugal.
Curr Pharm Des. 2015;21(25):3606-20. doi: 10.2174/1381612821666150710145753.
Diabetes mellitus (DM) is one of the most prevalent chronic diseases and has been a leading cause of death in the last decades. Thus, methods to detect, prevent or delay this disease and its co-morbidities have long been a matter of discussion. Nowadays, DM patients, particularly those suffering with type 2 DM, are advised to alter their diet and physical exercise regimens and then proceed progressively from monotherapy, dual therapy, and multi-agent therapy to insulin administration, as the disease becomes more severe. Although progresses have been made, the pursuit for the "perfect" antidiabetic drug still continues. The complexity of DM and its impact on whole body homeodynamics are two of the main reasons why there is not yet such a drug. Moreover, the molecular mechanisms by which DM can be controlled are still under an intense debate. As the associated risks, disadvantages, side effects and mechanisms of action vary from drug to drug, the choice of the most suitable therapy needs to be thoroughly investigated. Herein we propose to discuss the different classes of antidiabetic drugs available, their applications and mechanisms of action, particularly those of the newer and/or most widely prescribed classes. A special emphasis will be made on their effects on cellular metabolism, since these drugs affect those pathways in several cellular systems and organs, promoting metabolic alterations responsible for either deleterious or beneficial effects. This is a crucial property that needs to be carefully investigated when prescribing an antidiabetic.
糖尿病（DM）是最常见的慢性病之一，在过去几十年中一直是主要的死亡原因。因此，检测、预防或延缓这种疾病及其合并症的方法长期以来一直是讨论的话题。如今，建议糖尿病患者，尤其是2型糖尿病患者改变饮食和体育锻炼方案，然后随着病情加重，逐步从单一疗法、联合疗法和多药疗法过渡到胰岛素治疗。尽管已经取得了进展，但对“完美”抗糖尿病药物的追求仍在继续。糖尿病的复杂性及其对全身内环境稳定的影响是尚未有此类药物的两个主要原因。此外，控制糖尿病的分子机制仍在激烈争论中。由于不同药物的相关风险、缺点、副作用和作用机制各不相同，因此需要对最合适治疗方法的选择进行深入研究。在此，我们建议讨论现有的不同类别的抗糖尿病药物、它们的应用和作用机制，特别是那些较新的和/或处方最广泛的类别。将特别强调它们对细胞代谢的影响，因为这些药物会影响多个细胞系统和器官中的这些途径，促进导致有害或有益作用的代谢改变。这是在开抗糖尿病药物处方时需要仔细研究的关键特性。
