Page 43 - ITPS-7-3

INNOSC Theranostics and
Pharmacological Sciences Medicinal plants: Natural diabetes remedies

involving abnormal β-cell function are mutations in the of diabetes may vary and develop at different rates. For
genes KCNJ11 or ABCC8, 18,20 which code for the potassium example, the symptoms of T1DM usually develop over a
channel in pancreatic β-cells, and anomalies in the 6q24 short period, while those of T2DM develop more slowly. In
locus. Patients with mutations in KCNJ11 or ABCC8, as some individuals, no symptoms are present at all. In GDM,
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well as 6q24 abnormalities, are compliant with a successful symptoms may or may not develop during pregnancy,
switch from insulin injection (i.e., initially used as a mode necessitating testing for the condition. In general,
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of treatment) to oral sulfonylureas. 18,20 DM often presents asymptotically, but some significant
symptoms that develop or indicate a potential diabetic
2.6. Type 3c DM patient include those listed in Table 1.
Type 3c DM, also known as pancreatogenic diabetes or
pancreatic DM, results from conditions affecting the 3.2. Treatment
exocrine pancreas, such as pancreatic cancer, chronic There is currently no approved cure for DM; therefore,
pancreatitis, and cystic fibrosis. Due to its association management and treatment of the disease are the primary
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with pancreatic diseases, patients with T3cDM often courses of action. The treatment of DM is complex and
experience pancreatic exocrine insufficiency, leading to fat involves a combination of exercise, pharmacotherapy,
malabsorption and undernutrition. The pathogenesis of and nutritional therapy as interventions for successful
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T3cDM is due to decreased insulin production, facilitated disease management. The primary goal of DM treatment
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by both the reduction in the functional capacity of the is to maintain healthy blood glucose levels to prevent
islets and a decrease in their number due to extensive DM-related complications. Patients living with DM
sclerosis and fibrosis. Similar to T1DM and T2DM, are encouraged to consume proteins, carbohydrates,
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controlling hyperglycemia remains the primary target for and fats in appropriate nutritional proportions. This
minimizing the risk of macrovascular and microvascular recommendation entails carbohydrate intake comprising
complications. However, there are few studies or 55 – 60% of total caloric intake, limiting fat intake to a
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randomized trials on the pharmacological treatment maximum of 30%, and ensuring protein intake within
of T3cDM due to the unique and variable clinical and 10–20% of total daily intake. The expected caloric intake
metabolic characteristics of these patients. 21,22 is an average of 30 kcal/kg body weight. As part of their
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treatment regimen, individuals with diabetes are advised
2.7. Latent autoimmune diabetes in adults (LADA) to engage in at least 20 min of aerobic exercise per day
LADA is a subtype of T1DM that appears to bridge the (at least 150 min/week). This regimen of exercise helps in
gap between T1DM and T2DM. LADA is characterized by lowering blood glucose levels. Regular exercise also assists
a slow progression of autoimmune diabetes and exhibits in regulating blood cholesterol levels, lowering blood
immunological markers typical of T1DM but does not pressure, and maintaining a healthy body weight. 25
necessarily require insulin treatment upon diagnosis. Pharmacotherapy treatment depends on the type of
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Sometimes referred to as type 1.5 diabetes, LADA displays DM diagnosed. T1DM is primarily caused by the absence
some characteristics closer to T1DM, while others are closer of insulin, so daily insulin injections or the use of an insulin
to T2DM. The diagnosis of LADA is more commonly pump is the recommended forms of treatment. GDM also
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made in secondary care settings compared to primary requires insulin administration as a mode of treatment.
care. The critical diagnostic criteria for LADA include The initial insulin dosage is 0.5–1 unit/kg in individuals
adult onset (>30 years old), the presence of autoantibodies with T1DM. Several oral medications are available for
associated with diabetes, and no immediate requirement managing T2DM (Table 2), while insulin injections
for insulin therapy post-diagnosis. 23,24 LADA patients may also be required. The choice of oral drug therapy is
retain functioning β-cells; therefore, it is imperative to complex, and physicians rely on clinical judgment to
initiate therapeutic strategies aimed at improving metabolic determine the most effective combination of drugs for the
control while preserving the insulin-secreting capacity. 24 patient. It is important to note that discretion is critically

3. Symptoms and treatment of DM essential over a long period as the treatment of persistent,
chronic diseases such as DM are ongoing and unrelenting,
3.1. Symptoms and the response to therapy may potentially change over
The symptoms of DM may appear harmless when time. 25-27
considered individually, which is the primary reason While the oral medications listed in Table 2 are
why people may have diabetes without being aware of commonly used for managing diabetes, they often fail
the predicament. The symptoms of the different types to completely control the condition and may exhibit

Volume 7 Issue 3 (2024) 3 doi: 10.36922/itps.1885