Vybhavi V S Jyothi, Bhavsar Milav, Gusani Jigar, Gohil Yashrajsinh, Paul Nawal K, Garlapati Himaja Reddy, Shrivastava Kirtika
Department of Physiology, Raja Rajeswari Medical College and Hospital, A Constituent Institution of Dr M G R Educational and Research Institute, Chennai, Tamil Nadu, India.
Department of Biochemistry, Bhagyoday Medical College, Kadi, Mehsana, Gujarat, India.
J Pharm Bioallied Sci. 2025 Jun;17(Suppl 2):S1070-S1072. doi: 10.4103/jpbs.jpbs_1759_24. Epub 2025 Jun 18.
Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder characterized by chronic hyperglycemia resulting from insulin resistance, impaired insulin secretion, and dysregulated glucose homeostasis. Despite advances in understanding its clinical presentation and management, the underlying pathophysiological mechanisms remain incompletely elucidated. Recent research has unveiled novel insights into the intricate interplay between genetic, epigenetic, and environmental factors in the development and progression of T2DM. This review aims to provide a comprehensive overview of these emerging paradigms, including the role of gut microbiota, low-grade inflammation, lipid toxicity, and mitochondrial dysfunction. Furthermore, the influence of β-cell heterogeneity, the interplay of incretin hormones, and the impact of circadian rhythms on glucose metabolism are explored. These insights pave the way for precision medicine approaches, offering new therapeutic targets and personalized strategies for T2DM management. By synthesizing current evidence, this review highlights the multifactorial nature of T2DM and underscores the need for a multidisciplinary approach to unravel its complexities.
2型糖尿病（T2DM）是一种复杂的代谢紊乱疾病，其特征为因胰岛素抵抗、胰岛素分泌受损及葡萄糖稳态失调导致的慢性高血糖。尽管在理解其临床表现和管理方面取得了进展，但其潜在的病理生理机制仍未完全阐明。最近的研究揭示了遗传、表观遗传和环境因素在T2DM发生发展过程中复杂相互作用的新见解。本综述旨在全面概述这些新兴范式，包括肠道微生物群、低度炎症、脂质毒性和线粒体功能障碍的作用。此外，还探讨了β细胞异质性的影响、肠促胰岛素激素的相互作用以及昼夜节律对葡萄糖代谢的影响。这些见解为精准医学方法铺平了道路，为T2DM管理提供了新的治疗靶点和个性化策略。通过综合当前证据，本综述强调了T2DM的多因素性质，并强调需要采用多学科方法来揭示其复杂性。
