Department of Biotechnology, National Institute of Technology Raipur, Raipur, Chhattisgarh, India.
Department of Biochemistry, Patna University, Patna, Bihar, India.
Pharmacol Rep. 2017 Oct;69(5):959-970. doi: 10.1016/j.pharep.2017.04.003. Epub 2017 Apr 9.
World Health Organization (WHO) has identified diabetes as one of the fastest growing non-communicable diseases with 422 million patients around the world in 2014. Diabetes, a metabolic disease, is characterized primarily by hyperglycemia which results in various macrovascular and microvascular complications like cardiovascular disease and neuropathies which can significantly deteriorate the quality of life. The body either does not manufactures enough insulin (type 1 diabetes or T1DM) or becomes insensitive to physiologically secreted insulin or both (type 2 diabetes or T2DM). The majority of the diabetic population is affected by type 2 diabetes. Currently, hyperglycemia is treated by a broad range of molecules such as biguanides, sulfonylurea, insulin, thiazolidinediones, incretin mimetics, and DPP-4 inhibitors exerting different mechanisms. However, new drug classes have indeed come in the market such as SGLT-2 inhibitors and other are in the experimental stages such as GPR 40 agonists, GSK-3 inhibitors, GK activators and GPR21 inhibitors which definitely could be anticipated as safe and effective for diabetes therapy. This article reviews the general approach to currently approved therapies for type 2 diabetes and focusing on novel approaches that could be a panacea and might be useful in the future for diabetes patients.
世界卫生组织(WHO)已将糖尿病确定为增长最快的非传染性疾病之一,2014 年全球约有 4.22 亿患者。糖尿病是一种代谢性疾病,主要特征是高血糖,可导致各种大血管和微血管并发症,如心血管疾病和神经病变,这会显著降低生活质量。身体要么不能制造足够的胰岛素(1 型糖尿病或 T1DM),要么对生理分泌的胰岛素不敏感,或者两者兼而有之(2 型糖尿病或 T2DM)。大多数糖尿病患者受 2 型糖尿病影响。目前,高血糖的治疗方法有很多种,如双胍类、磺酰脲类、胰岛素、噻唑烷二酮类、肠促胰岛素类似物和 DPP-4 抑制剂,它们发挥着不同的作用机制。然而,新的药物类别确实已经进入市场,如 SGLT-2 抑制剂,其他的则处于实验阶段,如 GPR40 激动剂、GSK-3 抑制剂、GK 激活剂和 GPR21 抑制剂,这些药物肯定可以被预期为安全有效的糖尿病治疗药物。本文综述了目前批准用于 2 型糖尿病的治疗方法,并重点介绍了一些新的方法,这些方法可能是一种万能药,对未来的糖尿病患者可能有用。