Abstract

DIABETOLOGY IN MODERN PHARMACY: AN UPDATED AND CONCISE REVIEW

*Sikander Ali Sheikh, Kashi Ram, Himanshu Soni, Lakhsya Panchariya

Abstract

Diabetes Mellitus (DM) has proliferated into one of the most formidable global public health crises of the 21st century, currently afflicting over 537 million adults worldwide with projections indicating a continuous surge. This comprehensive review article systematically analyzes the paradigm shift in modern diabetology, transitioning from traditional glucosecentric management to a holistic, organ-protective therapeutic approach. We critically examine the evolving pathophysiological models of both Type 1 and Type 2 DM, with a particular emphasis on DeFronzo’s "Ominous Octet," which elucidates the multi-organ metabolic defects driving chronic hyperglycemia, including pancreatic beta-cell failure, hepatic gluconeogenesis, and impaired incretin effect. Furthermore, this review dissects the current pharmacological landscape. While Biguanides (Metformin) remain the foundational first-line therapy, this paper highlights the revolutionary impact of novel agents—specifically Sodium-Glucose Cotransporter-2 (SGLT2) inhibitors and Glucagon- Like Peptide-1 Receptor Agonists (GLP-1 RAs). By synthesizing data from landmark cardiovascular outcome trials (such as EMPA-REG and LEADER), we outline how these advanced therapeutics offer unprecedented cardio-renal protection beyond mere glycemic control. Crucially, this article underscores the indispensable role of the clinical pharmacist in modern healthcare matrices. In an era dominated by complex polypharmacy, the pharmacist's clinical intervention through Medication Therapy Management (MTM), patient-specific pharmacotherapy optimization, and rigorous counseling on insulin delivery systems is vital for preventing adverse drug events like severe hypoglycemia. Finally, the review explores future therapeutic horizons, including closed-loop artificial pancreas systems, CRISPR-based gene editing, and stem cellderived beta-cell replacement, mapping the ultimate trajectory from chronic disease management toward definitive biological cures.

Keywords: Diabetes Mellitus, Metformin, Muti drug resistance, Herbal Formulation, Insulin.