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Innovative Medicines & Omics Herbal remedies for diabetes mellitus

2. Epidemiology 3.1. Type 1 DM

The rising prevalence of diabetes is closely linked to Type 1 DM is an autoimmune disease characterized by
lifestyle changes, obesity, and inadequate physical the destruction of insulin-producing pancreatic β-cells
activity, all of which contribute to insulin resistance (Figure 2). The development of T1DM is influenced by
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and metabolic dysfunction. The increasing incidence genetic susceptibility and environmental triggers, which
of youth-onset T2DM presents long-term healthcare initiate an autoimmune response. Autoimmune markers,
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challenges. These statistics underscore the urgent need such as glutamic acid decarboxylase autoantibodies
for improved diabetes prevention, early diagnosis, and (GAD65), insulin autoantibodies (IAAs), and islet cell
effective management strategies globally. According to autoantibodies (ICAs), are commonly detected in T1DM
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the National Non-Communicable Disease Monitoring patients. The rate of β-cell destruction varies among
Survey, 9.3% of Indian adults aged 18 – 69 years have patients. In children, the process is typically rapid, often
diabetes, while 24.5% exhibit impaired fasting glucose leading to early-onset diabetic ketoacidosis, whereas
levels. However, the rates of awareness (45.8%), in adults, β-cell destruction may occur more gradually,
treatment (36.1%), and glycemic control (15.7%) remain allowing for some residual insulin secretion during
suboptimal. Contributing factors include dietary shifts the early stages of the disease. Due to absolute insulin
and insufficient physical activity, resulting in a higher deficiency, T1DM necessitates lifelong insulin therapy. 22
prevalence of obesity, which further exacerbates the A range of autoantibodies is associated with T1DM,
diabetes burden. 14 including tyrosine phosphatase autoantibodies (IA-2 and
3. Classification and pathophysiology of IA-2α), IAAs, ICAs, autoantibodies targeting islet cell
antigen 512, GAD65, and autoantibodies against the islet-
DM specific zinc transporter isoform 8. 23
Despite its complex causes and diverse clinical 3.2. Type 2 DM
manifestations, the classification of DM remains crucial
for accurate clinical evaluation and effective treatment Type 2 DM is a chronic metabolic disorder characterized by
selection. DM is primarily categorized into four primary persistent hyperglycemia resulting from impaired insulin
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types: T1DM, T2DM, GDM, and MODY. The World secretion and insulin resistance. T2DM accounts for over
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Health Organization classification systems serve as a 90% of all diabetes cases globally. The pathogenesis of
key reference, though emerging research highlights the T2DM involves progressive β-cell dysfunction, leading to
necessity for updated classifications to better reflect the inadequate insulin release, coupled with peripheral insulin
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disease’s heterogeneity. Recent research has identified resistance in skeletal muscle, liver, and adipose tissue.
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four distinct subtypes of DM, each associated with unique Obesity, particularly increased visceral adiposity, plays a
risk factors and treatment responses, highlighting the crucial role in disease progression by inducing low-grade
importance of precision medicine in diabetes management chronic inflammation, excessive free fatty acid release, and
(Table 1). 17 adipokine dysregulation, all of which contribute to insulin

Table 1. Classification and pathophysiology of diabetes mellitus
Types of diabetes Description Percentage of Key characteristics References
mellitus case
Type 1 diabetes An autoimmune disorder characterized by the 5 – 10% Autoimmune destruction, presence of 18
mellitus destruction of pancreatic β-cells that produce autoantibodies (e.g., GADAs, ICAs,
insulin. IAAs), typically juvenile-onset.
Type 2 diabetes A metabolic disorder resulting from impaired 90 – 95% Insulin resistance and β-cell dysfunction, 19
mellitus insulin secretion due to β-cell dysfunction and usually adult-onset, are associated with
insulin resistance in peripheral tissues. obesity and lifestyle factors.
Gestational Usually happening in the 2 or 3 pregnancy 1 – 14% of all Insulin resistance during pregnancy is 20
rd
nd
diabetes mellitus trimester and resolving post-delivery. pregnancies a risk factor for future type 2 diabetes
mellitus in both mother and child.
Maturity-onset A monogenic form of diabetes caused by mutations Smaller Impaired insulin secretion results 21
diabetes of the in a single gene affecting insulin secretion from percentage from defects in pancreatic islet cell
young β-cells upon glucose activation. development.
Abbreviations: GADAs: Glutamic acid decarboxylase autoantibodies; IAAs: Insulin autoantibodies; ICAs: Islet cell antibodies.

Volume 2 Issue 2 (2025) 22 doi: 10.36922/imo.7520