Type 2 Diabetes Mellitus in Adult; Pathogenesis and Therapy: A review

Type 2 diabetes mellitus (DM) is a long-term metabolic condition with a steadily rising prevalence worldwide. This trend has led to its classification as an epidemic in certain countries, with the number of affected individuals projected to double over the next decade. This increase is largely attributed to an aging population, further straining healthcare systems, particularly in underdeveloped nations. This review draws upon data from Medline, the Cochrane Database of Systematic Reviews, and reference lists of pertinent publications. The search focused on subject headings and keywords such as type 2 diabetes mellitus, prevalence, diagnosis, and treatment. Only English-language articles were considered. Screening and diagnosis continue to follow the guidelines established by the World Health Organization (WHO) and the American Diabetes Association (ADA), incorporating both clinical evaluations and laboratory tests. Although there is currently no cure for the disease, available treatments include lifestyle changes, obesity management, oral hypoglycemic drugs, and insulin sensitizers. Metformin, a biguanide that reduces insulin resistance, remains the first-line therapy, especially for obese patients. Additional medications, such as non-sulfonylurea secretagogues, thiazolidinediones, alpha-glucosidase inhibitors, and insulin, have also proven effective. Recent advancements in the understanding of type 2 DM pathophysiology have resulted in the development of novel treatments. These include glucagon-like peptide-1 analogs, dipeptidyl peptidase-IV inhibitors, sodium-glucose cotransporter 2 inhibitors, and 11ß-hydroxysteroid dehydrogenase 1 inhibitors. Other innovations involve insulin-releasing glucokinase activators, pancreatic G-protein-coupled fatty-acid receptor agonists, glucagon-receptor antagonists, metabolic inhibitors targeting hepatic glucose production, and quick-release bromocriptine. Inhaled insulin, which was approved for use in 2006, has since been withdrawn from the market due to low consumer demand.