Diabetes Therapy
Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia which poses a serious threat to mankind. It poses a significant burden to patients and is mainly caused by decreased insulin activity or insulin secretion. Recent reports have suggested that approximately 387 million people are affected by diabetes mellitus globally. Population survey by the World Health Organization suggested that a total number of diabetic patients is further set to rise to 69.9 million in India by the year 2025. Most of the developing countries are getting affected due to this disease despite many scientific breakthroughs, better healthcare facilities, and improved literacy rate. Diabetes mellitus is broadly categorized into type 1 and type 2 diabetes. Type 1 diabetes (T1D) is caused by the destruction of the insulin-producing pancreatic beta cells. It is mostly caused in children depending upon several factors like age, family history, and environmental factors. 5-10% of patients account for T1D and they also have a higher risk for developing other autoimmune disorders such as Hashimoto’s thyroiditis, autoimmune hepatitis, Grave’s disease, and pernicious anemia. Type 1 diabetic patients are prone to ketoacidosis and can have permanent insulinogenic. Type 2 diabetes mellitus (T2DM) is characterized by disorders of insulin action and insulin secretion with symptoms of polyuria, thirst, recurrent blurred vision, paranesthesia, and fatigue. 90-95% of patients account for T2DM and are the fourth leading cause of death in developed countries. Blood glucose can be monitored by a blood-glucose testing, venous and capillary blood sample. Management of diabetes mellitus can significantly reduce the risk of complications of diabetes. Current strategies to treat diabetes include-
- Sulphonylureas
- Biguanides
- Alpha-glucosidase inhibitors
- Thiazolidinediones
- Incretin mimetics
- Amylin analogues
- GIP analogues
T2DM can be managed by non-pharmacological therapy, medical nutrition therapy, dietary fiber, artificial sweeteners, fruits, common salt, and physical activity. Pharmacological therapy consists of oral agents for the treatment of hyperglycemia. These treatments have been accompanied by certain limitations such as decreased potency, weight gain, lack of target specificity, and increased risk of hypoglycemia; therefore, advanced techniques are required to deliver insulin especially under recent ethical guidelines and safety concerns. These new and unique technologies individualized patient care with consideration of patient preference, cost, disease state, and medication profile. Intranasal, insulin pumps, continuous glucose monitoring (CGM) systems, pancreatic, and islet transplantation are some of the advanced methods for treating diabetes mellitus. Nanotechnology applications in treating diabetes mellitus has introduced unique strategies for glucose measurement and insulin delivery due to the potential benefits of nanoparticles in reduced dosing frequency, enhanced bioavailability, and fewer side-effects. Through this technology, plenty of genuine groundbreaking therapeutic advancements has come to use in our daily existence. Stem cell-based therapies hold the potential or providing a limitless source of glucose-responsive insulin-producing β cells and are gaining tremendous attention as an advanced technology to treat this metabolic disorder. The emergence of beta-cell encapsulation strategies can also be one of the approaches for successful therapeutic outcomes to treat diabetes mellitus.