AN OVERVIEW OF EMERGING PHARMACOLOGICAL TARGETS IN TREATMENT OF TYPE 2 DIABETES MELLITUS
Diabetes is a chronic disorder which has serious complications if not treated appropriately. A number of therapeutic agents exist for the treatment of type 2 diabetes including metformin, sulfonylureas, thiazolidinediones, α-glucosidase inhibitors, insulin, GLP-1 analogs and DPP-4 inhibitors. Despite a laborious list, they still suffer from few of the adverse effects like hypoglycemia, weight gain, edema, fractures, lactic acidosis etc. The objective of this article is to review the important drug classes currently in the development for the treatment of diabetes. Many new classes of drugs are in different stages of development which have novel mechanism of action and have shown promising results. These drugs mainly target the kidney, liver and pancreas as their prime target in bringing about glucose control. These new classes of drugs include Sodium-Glucose Cotransporter-2 inhibitors, Peroxisome proliferator activated receptor-α agonists,Fructose-1,6-bibhosphatase Glycogen phosphorylase inhibitors, Glucokinase activators, G-Protein coupled receptor 119 agonists, Glycogen synthase kinase-3 inhibitors, Protein tyrosine phosphatase-1b inhibitors, AMP activated protein kinase activators, Liver selective glucocorticoid receptor antagonist (LSGRA), 11β-hydroxysteroid dehydrogenase Type-1inhibitors, JNK activators,Free fatty acid receptor-1 (FFAR-1) agonists. Further exploration of these new targets for glycemic control will hopefully lead to development of safe and efficacious drugs that will become the mainstay of next generation therapeutics for diabetes and will reduce the clinical and cost burden of this disease.
KEY WORDS: Diabetes mellitus, emerging targets, current medications, gluconeogenesis, glycogenolysis.