Pharmacological managment of diabetes type 2
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In 2021, there were 529 million people of all ages, worldwide, living with diabetes. Type 2 diabetes occurs when the body is ineffective in the use of insulin. In type 2 diabetes, the pancreas produces the hormone insulin, but the cells are resistant to insulin. Lifestyle and genetic factors are the two main factors in the development of type 2 diabetes. The main pathophysiology of type 2 diabetes includes reduction of insulin secretion from the β cells and increased secretion of glucagon from the α-cells. The common signs and symptoms of type 2 diabetes are frequent urination, numbness of fingers and toes, feeling very thirsty, hungry and drinking a lot, feeling weak and tired, blurred vision, cuts or wounds that heal slowly, dry skin, unwanted weight loss, and infection. Measurement of HbA1c, FBS, and OGTT are the most valuable diagnostic criteria to check the blood sugar level and diagnose type 2 diabetes. A healthy lifestyle criterion like healthy foods, aerobic activities, weight loss, no smoking, and prohibition of alcohol consumption can help prevent type 2 diabetes. Although lifestyle changes such as diet modification and increased physical activity can be very effective in improving blood sugar control, in the long term most people who do not have normal blood sugar levels will need medication to achieve normal blood sugar levels. Fortunately, there are a lot of insulin and non-insulin medications for type 2 diabetes treatment. Injectable insulins are categorized as rapid, short, intermediate, and long-acting insulins. On the other hand, non insulin medications are sulfonylureas, meglitinides, metformin, TZDs, AGIs, SGLT-2 inhibitors, and bromocriptine. These drugs with different mechanisms of action can be used as monotherapy, or in combination with other drugs. However, a summary of first-line and further medications for type 2 diabetes treatment is illustrated in Tables 5 and 6. The last but not the least, due to the expansion of machine life and reduction of physical activities, educating people about ways to prevent diabetes is an inevitable thing to control the diabetes epidemic. On the other hand, new drugs are being developed to treat diabetes.