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Innovative Medicines & Omics Herbal remedies for diabetes mellitus

services. It plays a crucial role in diabetes education induced pluripotent stem cells, embryonic stem cells, and
and management. 41,42 The optimization of MNT for adult stem cells. 45,46
DM remains an area of ongoing research, particularly
concerning energy content, macronutrient distribution, 5.3. Oral hypoglycemic agents
and quantity. While MNT aims to develop diet plans that Oral hypoglycemic agents are widely used in the treatment
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are both evidence-based and patient-centered, concerns of T2DM. These agents include biguanides, sulfonylureas,
have been raised regarding its ability to balance medical meglitinides, thiazolidinediones, dipeptidyl peptidase
efficacy with patient preferences. Therefore, collaboration (DPP)-4 inhibitors, odium-glucose cotransporter 2
between diabetologists and registered dieticians is inhibitors, and α-glucosidase inhibitors (Table 3).
essential to establish evidence-based nutritional guidelines Biguanides, such as metformin, reduce hepatic glucose
for MNT in preventing and managing diabetes and its production and enhance insulin sensitivity, although
complications. 43 they can cause gastrointestinal discomfort and, in rare
cases, lactic acidosis. Sulfonylureas (e.g., glimepiride) and
5.2. Stem cell therapy meglitinides (e.g., repaglinide) stimulate insulin secretion
Stem cell research holds great promise for DM from pancreatic β-cells but are linked to hypoglycemia and
management. Stem cell therapy aims to restore β-cell weight gain. Thiazolidinediones (e.g., pioglitazone) improve
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function by replacing dysfunctional pancreatic cells with insulin sensitivity but may lead to weight gain, fluid retention,
multipotent stem cells. Various techniques have been and heart failure. DPP-4 inhibitors (e.g., sitagliptin) enhance
developed to generate β-cell substitutes or restore β-cell insulin release with a low risk of hypoglycemia, although
functionality using different stem cell sources, such as they may cause joint pain and pancreatitis. 47

Table 3. Treatment and management strategies for diabetes
Drug category Drug name Mechanism of action Side effects References
Rapid-acting insulin Insulin lispro, insulin aspart, insulin Acts by directly binding to Hypoglycemia, weight gain, 48,49
glulisine, technosphere Insulin its receptors on the plasma electrolyte disturbances,
Short-acting Regular human insulin membranes of the cells, leading to lip dystrophy, peripheral
a cascade of intracellular events hyperinsulinemia
Intermediate NPH human insulin that facilitate glucose uptake and
Long-acting Insulin detemir, insulin glargine, metabolism
insulin glargine-yfgn, insulin degludec
Insulin secretagogues Sulfonylurea (glimepiride, repaglinide, Suppress the β-cell K ATP channel Hypoglycemia, weight gain 50
+
glipizide) and promote the release of insulin
Meglitinides (nateglinide, glyburide)
GLP-1 agonists Liraglutide, exenatide, lixisenatide Reduce glucagon secretion, Pancreatitis 51,52
increase glucose-dependent insulin
secretion, and post-pone gastric
emptying
α-glucosidase inhibitors Acarbose, miglitol, voglibose Lower the rate at which glucose is Abdominal pain, diarrhea, 53
absorbed from carbohydrates by flatulence
slowing down their breakdown in
the gut
Sodium-glucose Canagliflozin, dapagliflozin, Raise the excretion of glucose in Urinary tract infection, 54
cotransporter 2 inhibitors empagliflozin urine hypotension
Dipeptidyl peptidase Vildagliptin, Linagliptin, Saxagliptin, Raises levels of endogenous Respiratory tract infection, 55,56
4 (DPP4 inhibitors) Sitagliptin GLP-1 and glucose-dependent nasopharyngitis, headache
insulinotropic polypeptide
Biguanides Metformin Reduce insulin resistance and Gastrointestinal irritation, 57
glucose generation by activating lactic acidosis
AMP-activated protein kinase
Thiazolidinediones Pioglitazone, Rosiglitazone Activate peroxisome Fluid retention, weight gain 58
proliferator-activated receptors to
reduce insulin resistance
Abbreviation: GLP-1: Glucagon-like peptide 1.

Volume 2 Issue 2 (2025) 26 doi: 10.36922/imo.7520