Therapeutic Approaches to Newer Classes of Drugs and Treatments for Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) is one of the most devastating concerns among the most frequent metabolic illnesses worldwide that are sparked by malfunctioning of the β cells and insulin resistance. There are now 537 million people living with diabetes worldwide; however, the International Diabetes Federation predicts that the number will rise to 783 million by the year 2045. Pathophysiological changes in the body, including nephropathy, retinopathy, and cardiovascular troubles, accompany the progression of the disease. 92 Medications that lower blood sugar levels orally include biguanides, insulin sensitizers, alpha-glucosidase inhibitors, incretin mimetics, amylin antagonists, and sodium-glucose co-transporter-2 inhibitors. Similarly, therapy of T2DM (monotherapy, dual therapy, triple therapy, and combination therapy) is recommended depending on the patient’s glycated hemoglobin value. Emerging classes of agents with encouraging preclinical data have emerged in recent years as a treatment for T2DM. Ongoing investigation is necessary to reduce the adverse impact profile of already available formulations and enhance their effectiveness, potency, and delivery to meet the expanding health concerns. In the present chapter, we have attempted to summarize the pathophysiologic dysfunction (ominous octet) of T2DM, the advancement of newer classes of drugs, treatment modalities (conventional and newer treatment algorithms), and clinical trial evidence supporting these classes of medications in T2DM therapy. Ultimately, this chapter will set the road for a thorough update on T2DM and its treatment algorithm.