Drug Design and Therapeutic Development for Diabetes Mellitus
The main objective in the treatment of diabetes is maintaining normal or near normal blood glucose levels with the aim of preventing the occurrence of acute and chronic complications. Major milestones in the treatment of type 1 diabetes, which necessitates immediate insulin therapy, have included the discovery and clinical application of insulin, transition from animal to human insulin, introduction of insulin analogues, the use of insulin pump therapy, and the artificial pancreas. More novel approaches under development include non-insulin based adjunct treatments (metformin, glucagon, incretin-based therapies, and gliflozins). Previously, the approach for the treatment of type 2 diabetes has been standardisation of therapy for all patients. However, a more personalised approach is now generally accepted. Despite introduction of more novel drugs for the treatment of type 2 diabetes (incretin-based therapies and sodium–glucose co-transporter 2 inhibitors), lifestyle modification coupled with metformin remains the cornerstone in the treatment of type 2 diabetes. The purpose of this chapter is to highlight the currently available therapeutic options for both type 1 and type 2 diabetes, particularly underscoring new drug designs, and highlighting findings from clinical and preclinical trials.