The Underlying Mechanisms and Novel Approaches for Diabetes and its Related Complications

Book excerpt: Diabetes mellitus is a chronic metabolic disease characterized by elevated blood glucose levels, which severely affects the quality of life and survival of patients. The latest data from the International Diabetes Federation showed that there are approximately 537 million diabetic patients globally in 2021, and it is expected to reach 783 million by 2045. The treatment regime of diabetic patients mainly refers to the management of blood glucose and its complications. At present, typical hypoglycemic medications include insulin and non-insulin hypoglycemic drugs, which can be subdivided into a-glucosidase inhibitors, metformin, thiazolidinediones, sulfonylureas, glinides, DPP-4i, GLP-1RA, and SGLT-2i. Diabetic patients with poor islet function usually require insulin replacement, but the majority of patients fail to meet ideal therapeutic targets with multiple hypoglycemic drug combinations (including insulin). Furthermore, poor glycemic control is closely associated with an increased risk of diabetes complications, consequently an increased rate of mortality. More recently, promising new drugs and therapies emerged, which have many other important benefits beyond glucose-lowering. In addition, some traditional Chinese medicine have gradually revealed their therapeutic advantages. All of them provide more choices for the treatment of diabetes patients.