New therapeutic approaches in type 2 diabetes mellitus

There is a strong association between obesity, insulin resistance and type 2 diabetes mellitus. Abdominal obesity appears to be a major mediator of insulin resistance and hyperinsulinemia. Insulin resistance is a pathological condition in which cells fail to respond normally to the hormone insulin. leading to high blood sugar (impaired glucose uptake in peripheral tissues, particularly in skeletal muscle.) The more life-threatening problems fall into four main areas: type 2 diabetes, cardiovascular diseases (CVD), dyslipidemia and certain types of cancers and musculoskeletal disorders. There is considerable evidence that inflammation is a primary mediator of obesity induced insulin resistance and related co-morbidities, including diabetes and CVD whereby pro-inflammatory substances and other chemokines produced by adipocytes and macrophages are able to cause insulin resistance. The major inflammatory factors include pro-inflammatory interleukins (IL-1 & IL-6) and signaling intermediate-nuclear factor kappa B cells (NF-kB), chemokines and cytokines, tumor necrosis factor alpha (TNF-α), adiponectin (ADN), circulating C-reactive protein (CRP) concentrations, toll-like receptors (Tlr), free fatty acids (FFA), oxidative stress and dietary fatty acids. Considering this viewpoint, in the present review, we have selected ten well designed clinical studies with salsalates, thiazolidinediones (TZD) and TNF-α–antagonists to discuss and analyze these emerging therapeutic approaches for the treatment of obesity induced insulin resistance and type 2 diabetes mellitus. These therapeutics provide sufficient evidence of improved glycemic control post treatment in obese patients by targeting the state of chronic inflammation that characterizes obesity and resulted in improved insulin sensitivity by reducing adipocyte pro-inflammatory cytokine expression, adipose tissue macrophage content and immune cell infiltration into adipose tissue and other inflammatory markers. Even with looking at only few studies, analyzing each pathway, the hypothesis that targeting pro-inflammatory pathways in adipocytes with TZD and salicylates as a novel approach remains supported for reducing chronic inflammation-induced insulin resistance in obese patients, with TZD emerging with the strongest effects.

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Acute coronary syndrome in patients with type 2 diabetes mellitus: analysis of Russian hospital care

Diabetes Mellitus ◽

10.14341/2072-0351-5515 ◽

2012 ◽

Vol 15 (2) ◽

pp. 27-31 ◽

Cited By ~ 2

Author(s):

Aleksey Dmitrievich Erlikh ◽

Nikolay Andreevich Gratsianskiy

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Acute Coronary Syndrome ◽

Hospital Care ◽

Clinical Characteristics ◽

Therapeutic Approaches ◽

Coronary Syndrome ◽

Registry Record

Aims. To analyze basic clinical characteristics, inhospital therapeutic approaches and outcomes in patients with acute coronary syndrome(ACS) and diabetes mellitus (DM). Materials and methods. Patients were included in this study according to the protocol, established for Russian ACS Registry (RECORD),based on data from 18 hospitals operating in 13 Russian cities. Results. 796 patients took part in the current study. 15.6% reported diagnosis of DM at admission. We observed positive correlationbetween initial glycemic levels and presence of DM (r=0.43; р

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An Insight of Alpha-amylase Inhibitors as a Valuable Tool in the Management of Type 2 Diabetes Mellitus

Current Diabetes Reviews ◽

10.2174/1573399815666190618093315 ◽

2020 ◽

Vol 16 (2) ◽

pp. 117-136 ◽

Cited By ~ 4

Author(s):

Roqia Bashary ◽

Manish Vyas ◽

Surendra Kumar Nayak ◽

Ashish Suttee ◽

Surajpal Verma ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Alpha Amylase ◽

Antidiabetic Agents ◽

Scientific Database ◽

New Therapeutic Approaches ◽

Good Target ◽

Amylase Inhibitors

Background: Among the millions of people around the world, the most prevalent metabolic disorder is diabetes mellitus. Due to the drawbacks which are associated with commercially available antidiabetic agents, new therapeutic approaches are needed to be considered. Alpha-amylase is a membrane- bound enzyme which is responsible for the breakdown of polysaccharides such as starch to monosaccharides which can be absorbed. Methods: We searched the scientific database using alpha-amylase, diabetes, antidiabetic agents as the keywords. Here in, only peer-reviewed research articles were collected which were useful to our current work. Results: To overcome the research gap, the alpha-amylase enzyme is regarded as a good target for antidiabetic agents to design the drug and provide an alternate approach for the treatment of type 2 diabetes mellitus. Basically, alpha-amylase inhibitors are classified into two groups: proteinaceous inhibitors, and non-proteinaceous inhibitors. Recently, non-proteinaceous inhibitors are being explored which includes chalcones, flavones, benzothiazoles, etc. as the potential antidiabetic agents. Conclusion: Herein, we discuss various potential antidiabetic agents which are strategically targeted alpha-amylase enzyme. These are having lesser side effects as compared to other antidiabetic agents, and are proposed to prevent the digestion and absorption of glucose leading to a decrease in the blood glucose level.

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