Molecular Pathology and Therapeutic Strategies of Type 2 Diabetes

Abstract

Diabetes Mellitus (DM) is a metabolic disorder characterized by hyperglycemia. Over the years, scientists have identified many factors that may have causal relationships with DM development. Identified factors are either genetic or environmental, and they may promote or prevent DM development. This review discusses various factors that are involved in the molecular pathogenesis, development, and therapeutic strategies of type 2 diabetes. DM is caused by interactions between multiple factors and triggers. Altered metabolic pathways and cellular functions, primarily in organs involved in glucose metabolisms, such as the pancreas and liver, often result in metabolic dysfunction, leading to DM. Additionally, abnormal levels of some factors, the presence of some pathogens, or the use of some types of medicine, such as immuno-inflammatory mediators, glucagon, apolipoprotein E4, chromogranin-A, exosomes, vitamin D, viruses, glucocorticoid medication, and antipsychotic drugs, may play roles in the development of DM. Some of these factors and mechanisms are well-studied, while others are more controversial and have contradicting experimental results. Further research is needed to confirm the roles of these factors in DM and fully understand how they contribute to DM development. Numerous medications for diabetics have been developed to help alleviate the symptoms of hyperglycemia and its complications. Several types of small compounds or peptide drugs with anti-diabetic effects can decrease blood glucose levels, improve insulin resistance, and inhibit key enzymes involved in the development and progression of diabetes. Here, we review the commonly used effective antidiabetic drugs, including the most recent innovative ones, such as GLP- 1R/GIPR and GLP-1R/GCGR agonists, and Chinese medicine.

Keywords: Diabetes mellitus; gluconeogenesis; glucose metabolism; glucose transport; glycogenolysis; insulin resistance.