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INNOSC Theranostics and
Pharmacological Sciences Medicinal plants: Natural diabetes remedies

Table 1. Symptoms of diabetes mellitus (DM)
Symptoms Description References
Polyuria (frequent urination) An increased glucose concentration from the blood accumulates in the kidneys and 25,26
attracts large volumes of water, resulting in frequent urination (from 1.8 L in healthy
people to over 3 L in those with DM).
Polydipsia (excessive thirst) Loss of substantial amounts of water through excessive urination results in dehydration 25,26
that, in turn, triggers a thirst that is difficult to satisfy.
Lethargy/Fatigue If there is no hormone insulin or it is malfunctioning, there would be no glucose uptake 25,26
into cells, resulting in listlessness and fatigue.
Polyphagia (intense hunger) Large amounts of sugars in the blood are not used in the cells as an energy source due to 25,26
the absence of insulin or its malfunction. The body’s reaction is to try and seek energy,
triggering the release of ghrelin and cortisol hormone (hunger hormones), and the
patient experiences increased hunger.
Ketoacidosis Due to the absence of sugar to fuel metabolism, the body turns to fats and proteins, and 25,26
the breakdown of fats results in the generation of acetone (ketones) used in metabolism.
Ketones lower blood pH (ketoacidosis) and are presented as a fruity smell on the breath,
urine, and sweat, as well as Kussmaul breathing (increased breathing rate).

Table 2. Types of oral medications, their action, and the available drug(s) for diabetes mellitus
Type of oral Action of drug Available drug References
medication
Biguanides Exhibits insulin-sensitizing properties in which it lowers Metformin 25,26,28
basal and postprandial plasma glucose and increases glucose
uptake by the periphery.
Sulfonylureas Stimulates insulin secretion by β-cells of the pancreas, Gliclazide, glimepiride, glipizide, and 25,26,28
leading to a drop in blood glucose level and a reduction of glibenclamide
basal hepatic glucose secretion.
α-glucosidase Acts within the small intestines, inhibiting α-glucosidase Miglitol and acarbose 25,26,28
inhibitors enzyme, thereby delaying digestion/absorption of ingested
carbohydrates and, in turn, lowering postprandial blood
glucose.
Thiazolidinediones Targets insulin resistance, enhancing insulin sensitivity to Rosiglitazone and pioglitazone 25,26,28
tissues in muscle through activation of intracellular receptors.
Meglitinides Increases insulin secretion by triggering pancreatic β-cells. Netaglinid and repaglinide 25,26,28
Sodium-glucose Block glucose reabsorption in the kidneys and improves Canagliflozin, ipragliflozin, 25,26,28
co-transporter 2 glucose excretion, in turn lowering blood glucose levels. dapagliflozin, and empagliflozin
inhibitors
Dopamine D2 and its Lowers resistance to insulin and improves insulin sensitivity. Bromocriptine 25,26,28
receptor agonist
Bile acid sequestrant Develops glucose-lowering effect and improves glucose Colestimide and colesevelam 25,26,28
tolerance.

negative side effects. Therefore, ongoing research is aimed several other medications for T2DM are discussed in
at developing improved treatments for DM. Although detail.
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the drugs that have been and are still being used have
proven to be effective, novel classes of innovative targets 3.2.1. Tirzepatide
for diabetic control and antihyperglycemic therapies have Tirzepatide is a dual incretin agonist that decreases
emerged to manage diabetes. The United States Food blood sugar and promotes weight loss reduction more
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and Drug Administration (FDA) approved tirzepatide, a competently than the usual treatments used for T2DM.
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new, unique, first-in-class medication for the treatment After meal consumption, the gut secretes hormones
of T2DM, on May 13, 2022. The drug is also known as known as incretins, which include glucagon-like
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Mounjaro. In the following subsections, tirzepatide and peptide-1 (GLP-1) and glucose-dependent insulinotropic

Volume 7 Issue 3 (2024) 4 doi: 10.36922/itps.1885