An update on Diabetes: An alarming situation

Abstract

With its increasing prevalence around the world,
diabetes is acknowledged as a serious chronic
pandemic disease that affects both developing and
developed economies equally and has been given
the status of "public health priority" in the majority
of those nations. Recent report of The Indian
Council of Medical Research-India
Diabetes (ICMR-INDIAB) says that 101
million people are estimated to be
suffered from diabetes and 136 million
people are found prediabetic. The report
gives an alarm to all of us to be alert or
be ready to face the results. Not only in
India, the number of people diagnosed with
diabetes is rising rapidly around the globe. Type 1,
Type 2, Gestational diabetes and other specific
types of diabetes such as LADA and MODY makes
four distinct forms of the disease. People with
diabetes experience fatigue, thirst, hunger,
urination, nausea, vomiting and loss of body fluids.
The non-functioning death of pancreatic beta cells
is the root cause of diabetes. Autoimmune diseases
including Addison's, Hashimoto's and
Graves'develop due to this. The likelihood of
developing diabetes is raised by predisposing
factors like genetics, family history, environment,
autoimmunity and high insulin resistance.
Diagnostic tests available that can diagnose
diabetes in its early and later stages. Miglitol,
Metformin, Nateglinide, Pioglitazone, Glipizide,
Dapagliflozin, Colestimide, Bromocriptine, etc. are
the modern medicines used to treat diabetes. Insulin
therapy, Stem cell therapy and islet replacement
therapy are the other methods utilized also to treat
diabetic patients. Due to the adverse effects of
modern medicines, use of herbal medicines is
recommended because of its less or no side effects
and also its easy availability, along with less intake
of carbohydrate, physical exercise and awareness
are required.

Full text

International Journal of Pharmaceutical Research and Applications
Volume 8, Issue 4 July-Aug 2023, pp: 1028-1037 www.ijprajournal.com ISSN: 2249-7781
DOI: 10.35629/7781-080410281037 | Impact Factor value 7.429 | ISO 9001: 2008 Certified Journal Page 1028
An update on Diabetes: An alarming situation
Tapan Kumar Mahato
*1
, Sunil Kumar Ojha
2
& Vikash Agnihotri
2
1Sardar Patel College of Pharmacy, Vidyanagar-Vadtal road, Bakrol, Taluka & District Anand,
Gujarat 388315, India
2B.Pharmacy College Rampura, At Rampura, PO Kankanpur, Taluka Godhra, District Panchmahal,
Gujarat 388713, India
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Submitted: 15-07-2023 Accepted: 25-07-2023
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ABSTRACT
With its increasing prevalence around the world,
diabetes is acknowledged as a serious chronic
pandemic disease that affects both developing and
developed economies equally and has been given
the status of "public health priority" in the majority
of those nations. Recent
report of The Indian
Council of Medical Research-India
Diabetes (ICMR-INDIAB) says that 101
million people are estimated to be
suffered from diabetes and 136 million
people are found prediabetic. The report
gives an alarm to all of us to be alert or
be ready to face the results.
Not only in
India, the number of people diagnosed with
diabetes is rising rapidly around the globe. Type 1,
Type 2, Gestational diabetes and other specific
types of diabetes such as LADA and MODY makes
four distinct forms of the disease. People with
diabetes experience fatigue, thirst, hunger,
urination, nausea, vomiting and loss of body fluids.
The non-functioning death of pancreatic beta cells
is the root cause of diabetes. Autoimmune diseases
including Addison's, Hashimoto's and Graves'
develop due to this. The likelihood of developing
diabetes is raised by predisposing factors like
genetics, family history, environment,
autoimmunity and high insulin resistance.
Diagnostic tests available that can diagnose
diabetes in its early and later stages. Miglitol,
Metformin, Nateglinide, Pioglitazone, Glipizide,
Dapagliflozin, Colestimide, Bromocriptine, etc. are
the modern medicines used to treat diabetes. Insulin
therapy, Stem cell therapy and islet replacement
therapy are the other methods utilized also to treat
diabetic patients. Due to the adverse effects of
modern medicines, use of herbal medicines is
recommended because of its less or no side effects
and also its easy availability, along with less intake
of carbohydrate, physical exercise and awareness
are required. Case study report/Interpretative paper
discusses all about diabetes.
I. INTRODUCTION
Diabetes, often referred as diabetes
mellitus is a group of metabolic diseases in which
the person has high blood glucose (blood sugar),
either because of inadequate Insulin production or
because the body’s cells do not respond properly to
insulin or both [5]. Diabetes treatment costs and
related consequences place a significant financial
strain on both the household and national
economies. The majority of diabetes patients in a
developing country like India bear a heavy
financial burden from out-of-pocket expenses. Over
the past few decades, India's diabetes prevalence
has increased due to rapid urbanization and socio-
economic changes such rural-to-urban migration, a
lack of exercise, lifestyle disorders, etc. By 2045,
the number is projected patients to be 134 million.
The estimated country-level health care spending in
India for diabetes mellitus was 31 billion US
dollars in 2017, placing India fourth in rank after
USA, China and Germany. When considering the
financial toll, diabetes alone consumes 5 to 25% of
the income of a typical Indian household. Lack of
knowledge about diabetes, its risk factors,
prevention techniques, healthcare systems, a poor
economy, non-adherence to medication etc. are the
things responsible for its continuous rise. Together,
these challenges and issues make a significant
contribution to the economic threat [3].
TYPES OF DIABETES
1)
Type 1 diabetes: The body does not produce
insulin. Some people may refer to this type as
Insulin-dependent diabetes, Juvenile diabetes
or Early-on set diabetes. People usually
develop type 1 diabetes before their 40th
year,
often in early adulthood or teenage years.
Patients with type 1 diabetes will need to
take insulin
injections for the rest of their life.
They must also ensure
proper blood-glucose

International Journal of Pharmaceutical Research and Applications
Volume 8, Issue 4 July-Aug 2023, pp: 1028-1037 www.ijprajournal.com ISSN: 2249-7781
DOI: 10.35629/7781-080410281037 | Impact Factor value 7.429 | ISO 9001: 2008 Certified Journal Page 1029
levels by carrying out regular blood tests and
following a special diet.
2)
Type2 diabetes: The body does not produce
enough
insulin for proper function or the
cells in the body do
not react to insulin
(Insulin resistance). Approximately
90% of all
cases of diabetes worldwide are type 2. Some
people may be able to control their type 2
diabetes symptoms by losing weight,
following a healthy diet, doing plenty of
exercise and monitoring their blood glucose
levels.
3)
Gestational diabetes
: Studies says that this
type affects females during pregnancy. Some
women have very high levels of glucose in
their blood and their bodies are unable to
produce enough insulin to transport all of the
glucose into their cells, resulting in
progressively rising levels of glucose.
Diagnosis of gestational diabetes is made
during pregnancy.
The majority of gestational diabetes
patients
can control their diabetes with exercise and
diet
[5].
4)
Other Specific Type of Diabetes (Monogenic
Types)
Genetic anomalies in the hormone insulin's
internal secretion are the cause of it. It is a disease
that develops from mutations in 1 to 5% of patients.
This includes infections, certain surgeries, genetic
beta cell abnormalities, cancer treatments, illnesses
of the pancreas and more. It has MOODY, LADA
and endocrinopathies kinds.
4.1 MODY (Maturity onset diabetes of young)
A mutation in an autosomal dominant gene
involved in insulin secretion or synthesis causes
MODY. Children under the age of 25 are
disproportionately affected by hereditary factors.
There appears to be a hereditary link to a problem
with beta cells. This form of diabetes typically
manifests in childhood.
4.2 LADA (Latent autoimmune diabetes in
adults) Lack of Insulin production by the
pancreas; otherwise, clinically indistinguishable
from Type 1. The inability of pancreatic cells to
produce insulin leads to LADA. Teenagers and
twenty-somethings experience LADA. The LADA
are not like the Type 1.
4.3 Endocrinopathies
Insulin's action or inhibition can be
affected by a number of illnesses and diseases.
Diseases and conditions that interfere with insulin
production include polycystic ovary syndrome
(PCOS), cancer of the pancreas and tumors [2].
WHAT IS PREDIABETES
The vast majority of patients with
type 2 diabetes
initially had prediabetes. Their blood glucose
levels where higher than normal but not high
enough to merit a diabetes diagnosis. The cells in
the body are becoming resistant to Insulin.
DIABETES IS A METABOLISM DISORDER
Diabetes (Diabetes mellitus) is classed
as a metabolism disorder. Metabolism refers to
the way our bodies used ingested food for energy
and growth. Most of what we eat is broken down
into glucose. Glucose is a form of sugar in the
blood-it is the principal source of fuel for our
bodies. When our food is digested, the glucose
makes its way into our blood stream. Our cells
use the glucose for energy and growth. However,
glucose cannot enter our cells
without insulin
being present Insulin makes it possible for
our cells
to take in the glucose. Insulin is a hormone that
is produced by the pancreas. After eating, the
pancreas automatically releases an adequate
quantity of insulin to
move the glucose present in
our blood into the cells, as soon
as glucose enters
the cells blood-glucose levels drop.
A person with diabetes has a condition
in which the quantity of glucose in the blood
is too elevated
(Hyperglycemia). This is because
the body does not produce
enough Insulin,
produces no Insulin or has cells that do not
respond properly to the Insulin the pancreas
produces. This
results in too much glucose
building up in the blood. This excess blood
glucose eventually passes out of the body in
urine. So, even though the blood has plenty of
glucose, the cells are not getting it for their
essential energy and growth requirements.
DIAGNOSIS OF DIABETES
Diabetes can often be detected by
carrying out a urine test, which finds out whether
excess glucose is present. This is normally
backed up by a blood test, which measures blood
glucose levels and can confirm
if the cause of the
symptoms is diabetes [4].
Diagnostic tests for diabetes, prediabetes or
neither [4]

International Journal of Pharmaceutical Research and Applications
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A patient has a normal metabolism, prediabetes or
diabetes can be determined by one of three different ways:
a. The A1C test (Glycated hemoglobin/Glycosylated hemoglobin/Hemoglobin A1C/HbA1C test)
Table 1: Shows AIC% in different conditions of diabetes, prediabetes and normal
S.NO.
CONDITION
A1C%
1
Diabetes
At least 6.5%
2
Prediabetes
Between 5.7% and 5.99%
3
Normal
Less than 5.7%
Figure 1: Graph shows the AIC% for diabetes, prediabetes and normal
b. The FPG (Fasting plasma glucose) test
Table 2: Shows the FPG levels in conditions of diabetes, prediabetes and normal
S.NO.
CONDITION
FPG LEVEL
1
Diabetes
At least 126 mg/dl
2
Prediabetes
Between 100 mg/dl and 125.99 mg/dl
3
Normal
Less than100 mg/dl
0 0 0
6.5 5.99 5.7
0
1
2
3
4
5
6
7
1 2 3 4
AIC % FOR DIABETES, PREDIABETES AND NORMAL
Condition AIC%
0 0
126
100
0
20
40
60
80
100
120
140
1 2 3 4
FPG LEVEL
CONDITION FPG LEVEL

International Journal of Pharmaceutical Research and Applications
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Figure 2: Graph shows the FPG levels for diabetes, prediabetes and normal
c. The OGTT (Oral glucose tolerance test)
Table 3: Shows OGTT levels for diabetes, prediabetes and normal
S.NO.
CONDITION
INFERENCE
1
Diabetes
At least 200mg/dl
2
Prediabetes
Between 140 and 199.9 mg/dl
3
Normal
Less than140mg/dl
Figure 3: Graph shows the OGTT levels of diabetes, prediabetes and normal
Treatment of Type 1 & 2 diabetes:
Diabetes type1 lasts
a lifetime, there is no
known cure. Type 2 usually lasts a life time;
however, some people have managed to get rid
of their symptoms without medication, through a
combination of yoga, exercise, diet and body
weight control.
Patients with type 1 are treated with
regular insulin
injections, as well as a special diet,
yoga and exercise. Patients with Type 2 diabetes
are usually treated with tablets, exercise
and a
special diet but sometimes insulin injections are
also required. If diabetes is not adequately
controlled the patient has a significantly higher
risk of developing complications.
COMPLICATIONS LINKED TO BADLY CONTROLLED/UNTREATED DIABETES
Table 4: Below is a list of possible complications that can be caused by badly controlled diabetes [4]:
S.No.
COMPLICATIONS
DISEASES/PROBLEMS
1
Eye complications
Glaucoma, Cataracts, Diabeticretinopathy and some
others.
2
Foot complications
Neuropathy, Ulcers and sometimes gangrene.
3
Skin complications
Skin infections and skin disorders.
4
Heart problems
Ischemic heart disease, when the blood supply to the
heart muscle is diminished.
5
Hypertension
Common in people with diabetes, which can raise the
risk of kidney disease, eye problems, heart attack and
stroke.
6
Mental health
Uncontrolled diabetes raises the
risk of suffering from
depression, anxiety and some
other mental disorders.
0 0
200
140
0
50
100
150
200
250
1 2 3 4
OGTT LEVEL
CONDITION INFERENCE

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7
Hearing loss
Diabetes patients have a higher risk of developing
hearing problems.
8
Gum disease
Much higher prevalence of gum disease among diabetes
patients.
9
Gastroparesis
Stomach muscles stop working properly.
10
Ketoacidosis
A combination of ketosis and
acidosis; accumulation of
ketone bodies and acidity
in the blood.
11
Neuropathy
Diabetic neuropathy is a type of nerve
damage which
can lead to several different problems.
12
HHNS (Hyperosmolar
Hyperglycemic Nonketotic
Syndrome)
Blood glucose levels shoot up too high and there are no
ketones present in the blood or urine. It is an emergency
condition.
13
Nephropathy
Uncontrolled blood pressure can lead to kidney disease.
14
PAD (Peripheral arterial disease)
Pain in the leg, tingling and sometimes problem in
walking.
15
Stroke
If blood pressure, cholesterol levels, and blood glucose
levels are not controlled, the risk of stroke is very high.
16
Erectile dysfunction
Male impotence.
17
Infections
People with uncontrolled diabetes are much more
susceptible to infections.
18
Healing of wounds
Delay in healing of cuts and lesions.
SYMPTOMS OF DIABETES
Table 5: Here is a list of the most common diabetes symptoms [4]:
S.No.
Symptoms
What/Why happens?
1
Frequent urination
When there is too much glucose (sugar) inthe blood, urination occurs
more often. If Insulin is ineffective, the kidneys cannot filter the
glucose back into the blood. The kidneys will take water from the
blood in order to dilute the glucose - which in turn fills up the
bladder.
2
Disproportionate thirst
If urination is more than usual, there is a need to replace that lost liquid.
3
Intense hunger
As the insulin in the blood is not
working properly or is not there at all,
and the cells are not getting their energy, your body may react by
trying to find more energy-food. You will become hungry.
4
Weight gain
Intense hunger.
5
Unusual weight loss
This is more common among
people with Diabetes Type 1 because the
body is not making insulin it will seek out another energy
source (the
cells aren’t getting glucose). Muscle tissue and fat will be broken down
for energy. As Type1 is of a more sudden onset and Type2 is much more
gradual, weight loss is more noticeable with Type1.
6
Increased fatigue
If insulin is not working properly or is not there at all, glucose will
not enter the cell sand provide them energy. This will make tired.
7
Irritability
Irritability can be due to lack of energy.
8
Blurred vision
This can be caused by tissue being pulled from the eye lenses. This
affects the eyes
ability to focus. With proper treatment this can be
treated. There are severe cases where blindness or
prolonged vision
problems can occur.
9
Cuts and bruises don’t
Cuts and bruises take much longer time than usual to heal. When

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heal properly or quickly
there is more sugar (glucose) in the body, its ability to heal is
reduced.
10
More skin and/or yeast
infections:
When there is
more sugar in the body, its ability to recover from
infections is affected. Women with diabetes have difficulty to
recover from bladder and vaginal infections.
11
Itchy skin
A feeling of itchiness on the skin is sometimes a symptom of diabetes.
12
Gums are red and/or
swollen-Gums pull away
from teeth
If the gums are tender, red and/or swollen this could be a sign of
diabetes. The teeth could become loose as the gums pull away from
them.
13
Frequent gum
disease/infection
Experience of more frequent gum disease and/or gum infections.
14
Sexual dysfunction
among men
In age of 50 years or more, frequent experience of constant sexual
dysfunction (Erectile dysfunction), it could be a symptom of
diabetes.
15
Numbness or tingling,
especially in feet and
hands
If there is too much sugar in the body, the nerves could be come
damaged, as could the tiny blood vessels that feed those nerves. One
may experience tingling and/or numbness in hands and feet.
RECENT REPORT OF THE INDIAN
COUNCIL OF MEDICAL
RESEARCH-INDIA DIABETES
(ICMR-INDIAB)
ICMR-INDIAB did a
study/survey to find out how common
metabolic no communicable diseases
(NCDs) are in the country. The NCDs are
diseases that can't be spread from person
to person. The survey was done between
2008 and 2020 in 31 states and union
territories including1, 13, 043 people
(33,537 urban people and 79,506 rural
people). The results found are given in
the table below and number of people
included in the survey.
Table 6: ICMR-INDIAB’s Non-communicable diseases estimations
S.No.
Particulars
Estimations
1
Diabetes
101 million estimated
2
Prediabetes
136 million found
3
Hypertension
315 million found
4
Generalized obesity
254 million
5
Abdominal obesity
351 million
6
Hypercholesterolaemia (Highcholesterol)
213 million
7
High LDL cholesterol or bad cholesterol.
185 million
The survey also revealed that the
southern and northern regions of India had
the greatest rates of diabetes prevalence,
with urban areas like Kerala, Puducherry,
Goa, Sikkim, and Punjab reporting the
highest rates of NCDs in comparison to
other regions of India. The findings of the
population-based, cross-sectional study on
persons over the age of 20 revealed that:
i.
The prevalence of generalised obesity
was substantially greater in females.
Only high cholesterol was considerably
greater in males, while
hypercholesterolemia, low HDL
cholesterol and high LDL cholesterol
were significantly higher in females.
ii.
The only lipid parameter that was
significantly higher in males was high
cholesterol.
iii.
The prevalence of prediabetes was
found to be at its lowest in Punjab,
Jharkhand, and certain portions of the
north-eastern region of India.
iv.
It was found to be at its highest in the
central and northern regions of India.
On the other hand, there was no
discernible difference between urban
and rural locations in terms of the
prevalence of prediabetes.
v.
Other cardiometabolic risk factors, such
as obesity, hypertension, and
dyslipidemia, have a prevalence that is

International Journal of Pharmaceutical Research and Applications
Volume 8, Issue 4 July-Aug 2023, pp: 1028-1037 www.ijprajournal.com ISSN: 2249-7781
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uniformly high across the country,
particularly in metropolitan regions.
This is especially true for the
prevalence of obesity. In general,
hypertension was quite common across
the country with the exception of the
central region; nevertheless, it was
more widespread in the metropolitan
areas.
vi.
When compared to rural areas, the
prevalence rates of generalised obesity
as well as abdominal obesity were
shown to be significantly higher in
urban areas.
vii.
Although rates of abdominal obesity
were high across the board in India, the
southern region had the highest
prevalence of obesity overall, followed
by the northern and eastern parts of the
country.
viii.
There was not much of a difference
between urban and rural areas in terms
of the prevalence of high
hypertriglyceridemia and low HDL
cholesterol. This was the case
throughout India.
ix.
Hypercholesterolemia and high LDL
cholesterol revealed a wide range of
interstate and interregional variability,
with the highest frequency found in the
northern area, Kerala, and Goa.
x.
According to the study, the prevalence
of diabetes and related NCDs putting a
large population at risk for both
cardiovascular disease and chronic
complications of diabetes like kidney,
foot, and eye disease, the treatment of
which is extremely expensive for both
the individual and society as a whole.
xi.
Furthermore, the prevalence of obesity
and prediabetes is high throughout the
nation (even in areas where the
prevalence of diabetes is currently low),
which suggests that the epidemic will
continue to spread.
xii.
According to the article, rural areas
generally lack the infrastructure
necessary to care for a growing number
of people with diabetes and its
complications. This makes the
universally high incidence of prediabetes
in these places a cause for serious
concern [1].
Table7: Different parameters of Diabetes Mellitus
Type 1
Type 2
MODY
LADA
Typical Age of Onset
Youth
Adult
Youth
Adult
Presence of Autoantibodies
Yes
No
No
Yes
Insulin Dependence
Yes
No
Not Always
Yes, within years
Insulin Resistance
No
Yes
Yes
No
Progression to Insulin
Dependence
Rapid
Slow
Slow
Month/Year
DIAGNOSTIC/LABORATORY TESTS
Fasting plasma glucose test, Oral glucose
tolerance test, Random blood glucose test,
Hemoglobin AIC test and O’Sullivan Test (GD can
be evaluated with this test. Fifty grammes of
glucose is given to a patient who has been fasting
for several hours. Every hour, a blood sample is
taken. When plasma concentrations above 1500
ng/mL, GD is suspected.)
MANAGEMENT OF DIABETES
Since type 1 is brought on by an
autoimmune deficiency, it cannot be prevented.
Simple modifications to one's diet and fitness
routine through exercise are at the heart of the vast
majority of diabetes preventative and treatment
plans. Genes and ageing are contributing factors to
Type 2. Methods to postpone or avoid developing
Type 2 diabetes are discussed below.
i. If you are overweight, you should make an effort
to lose weight by engaging in both regular exercise
and a nutritious diet. Aim for 20 minutes or more
of aerobic exercise each day. A person becomes
physically, mentally, and socially healthy via
regular exercise. Exercise on a regular basis helps
to maintain a healthy body weight, lower blood
sugar levels, and manage high blood pressure and
high cholesterol. As a result, the risk of disorders
like cardiovascular diseases that are associated to
those conditions is reduced. Long stretches of
inactivity are another risk factor for Type 2
diabetes. Bariatric surgery may also be an option
for obese individuals with a BMI > 35.
a. Carbohydrates should be eliminated from the

International Journal of Pharmaceutical Research and Applications
Volume 8, Issue 4 July-Aug 2023, pp: 1028-1037 www.ijprajournal.com ISSN: 2249-7781
DOI: 10.35629/7781-080410281037 | Impact Factor value 7.429 | ISO 9001: 2008 Certified Journal Page 1035
diet.
b. Increase your intake of fruits, veggies, and
whole grains every day.
c. There is a lot of sugar in alcohol, so
drinking it in large quantities is unhealthy.
Insulin Therapy
Insulin therapy is used to treat Type 1
diabetics. The aim of insulin therapy is to keep
blood sugar levels under control or maintained.
Using an insulin pump, insulin pen, or syringe, it is
administered subcutaneously.
Table 9: Types of Insulin
Particulars
Categories of Insulin
Rapid acting
Short/regular
acting
Intermediate
acting
Long acting
Ultra long
acting
Onset
15 minutes
30 minutes
2-4 hours
2 hours
6 hours
Peak time
1-2 hours
2-3 hours
4-12 hours
No peak
No peak
Duration
2-4 hours
3-6 hours
12-18 hours
24 hours or
more
36 hours or
more
Example
Humulin R,
Velosulin R
Humulin R,
Novolin N
Degludec,
Glargine
Glarginer,
Detemir,
Degludec
Glargine U-300
Islet Replacement Therapy
Traditional in vitro therapies such as
insulin injections have the drawback of not
effectively treating diabetes. For diabetic patients,
islet replacement therapy is an alternative form of
care. In this therapy, pancreatic or islet cell
transplants are used to replace beta cells that
produce insulin. Given the poor success rate, it is
occasionally employed. Islet transplants present a
number of difficulties, including a lack of available
donors, proper islet graft function, long-term
survival, etc.
Stem cell therapy
Stem cells play a crucial role in human
development. Type 1 diabetes can be treated with
stem cell treatment. To reverse Type 1 diabetes, we
need more than just a replacement for the
pancreatic beta cells that have been destroyed by
the disease. Stem cells have this quality, which aids
in the healthy operation of insulin-producing
pancreatic beta cells, which keeps blood sugar
levels stable [2].
MODERN MEDICINES TO TREAT DIABETES
Table10:Modern anti-diabetic drugs with its generic name and action [2]
Generic name of drug
Drug category
Drug action
Adverse effects
Acarbose, Miglitol
Alpha glucosidase
inhibitors
Slow breakdown of
oligosaccharide and
disaccharides into
monosaccharides,
prevents/delays absorption
Flatulence and diarrhea
Metformin
Biguanides
Lowers the hepatic
glucose output and
increase uptake of glucose
by the periphery,
including skeletal muscle.
Moderate weight loss
Repaglinide, Netaglinide
Meglitinides
Its trigger the beta cells of
the pancreas to increase
the secretion of insulin.
Hypoglycemia
Pioglitazone,
Rosiglitazone
Thiazolidinediones
It improves insulin
sensitivity in adipose
tissue and skeletal muscle
for good work
Skin allergies, chest pain,
heart failure
Glimepride,
Glibenclamide, Glipizide
Sulfonylureas
Increase insulin secretion
by stimulating beta
Hypoglycemia,
cardiovascular diseases

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pancreatic cells
Empagliflozin,
Canagliflozin, Ipraglifozin
Sodium glucose co-
transporter
inhibitors
Lower blood glucose
levels by blocking the
reabsorption of glucose in
the kidney and improve
glucose excretion
Vaginal yeast infections,
Urinary tract infections
Colesevelam, Colestimide
Bile acid
sequestrants
Developed glucose
lowering effect and
improved tolerance
Constipation, heart burn,
bloating
Bromocriptine
Dopamine D2
receptor agonist
Improves insulin
sensitivity and lower
insulin resistance.
Cardiac arrhythmia,
hypotension
HERBAL MEDICINAL DRUGS USED FOR
DIABETES
The medicinal plants and herbs are
currently being used in various configurations for
their anti-diabetes activity. Multiple clinical studies
have confirmed that extracts from healing herbs
have an anti-diabetic effect and can restore
pancreatic-cell function [4].
Table 11: List of some reported herbal drugs used to treat diabetes
S.No.
Scientific name
Local name
Family
1
Aloe barbadensis
Ghritkumari, Ghikanvar
Liliaceae
2
Allium sativum
Garlic, Lassan
Liliaceae
3
Ocimum sanctum
Tulsi
Labiateae
4
Coriandrum sativum
Dhaniya
Apiaceae
5
Aegle marmelos
Bael
Rutaceae
6
Tinosporacardifolia
Giloy, Guduchi, Amrita
Menispermaceae
7
Mangifera indica
Aam
Anacardiaceae
8
Momordica Charantia
Bitter Gourd, Karela
Cucurbitaceae
9
Allium Cepa
Onion, Pyaz
Liliaceae
10
Azadirachta indica
Neem
Meliaceae
11
Eugenia jambolana
Jamun, Kala jamun,
Blackberry
Myretaceae
12
Gymnemasylvestre
Gudmar, Meshashringi
Asclepidaceae
13
Carica papaya
Papita
Caricaceae
14
Psidium Guajava
Guava, Amrood
Myrtaceae
15
Thea Sinesis
Tea
Theaceae
II. CONCLUSION
Types, symptoms, causes, diagnosis, and
treatment of Diabetes are all covered in this article.
Diabetes has evolved into a widespread, age-
independent disease. While insulin therapy and
other anti-diabetic medications can help manage
diabetes for some time, the illness itself cannot be
cured. Diabetic patients must adhere to a healthy
diet and maintain a regular exercise routine. The
number of people with diabetes in India and
elsewhere is rising rapidly. Without effective
treatment, the disease will spread to many people
all over the world. An extremely common
endocrine condition that affects many people
worldwide is diabetes mellitus. It is a group of
metabolic infections characterized by
hyperglycemia brought on by abnormalities in
insulin release, activity, or both. Moving the
research towards generally available medications
with low symptom and wide range of bio action
and don't require difficult pharmaceutical
combination appears to be profoundly important
given the growth in obstruction and populations of
patients at some risk, related to the limited number
of commercially available medications for diabetes
that despite everything present have many side
effects and furthermore issues like undesirable
hypoglycemic impact. When creating medications
and treating the hyperglycemic problem associated
with diabetes mellitus, substances and concentrates
that are not derived from various common
resources play a vital role. The purpose of this

International Journal of Pharmaceutical Research and Applications
Volume 8, Issue 4 July-Aug 2023, pp: 1028-1037 www.ijprajournal.com ISSN: 2249-7781
DOI: 10.35629/7781-080410281037 | Impact Factor value 7.429 | ISO 9001: 2008 Certified Journal Page 1037
article is to inform readers that there are western
medications and Indian traditional healing herbs
available for the treatment of diabetes mellitus. For
this reason, medicines developed in accordance
with the principles of western medicine (Allopathy)
are sometimes limited in their viability, carry the
risk of adverse effects, and are frequently
unnecessarily expensive, especially for developing
countries like India. To manage type-1 and type-2
diabetes mellitus and related complications,
medicinal herbs are used. The use of medicinal
homegrown plants as a treatment for diabetes is
widely accepted worldwide.
ACKNOWLEDGEMENT
I would like give my sincere thanks to the authors
of the articles mentioned in reference because of
whom I succeeded in writing this article.
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