Title:Diabetic Complications: An Update on Pathobiology and Therapeutic
Strategies
Volume: 18
Issue: 1
Author(s): Karthika Nellaiappan, Kumari Preeti, Dharmendra Kumar Khatri and Shashi Bala Singh*
Affiliation:
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Hyderabad, Telangana-500037,India
Keywords:
Diabetes, diabetic neuropathy, diabetic kidney disease, diabetic retinopathy, diabetic heart disease, pathophysiology, drug-discovery.
Abstract: Despite the advent of novel therapies which manage and control diabetes well, the increased
risk of morbidity and mortality in diabetic subjects is associated with the devastating secondary
complications it produces. Long-standing diabetes majorly drives cellular and molecular alterations,
which eventually damage both small and large blood vessels. The complications are prevalent
both in type I and type II diabetic subjects. The microvascular complications include diabetic
neuropathy, diabetic nephropathy, diabetic retinopathy, while the macrovascular complications
include diabetic heart disease and stroke. The current therapeutic strategy alleviates the complications
to some extent but does not cure or prevent them. Also, the recent clinical trial outcomes in
this field are disappointing. Success in the drug discovery of diabetic complications may be
achieved by a better understanding of the underlying pathophysiology and by recognising the crucial
factors contributing to the development and progression of the disease. In this review, we discuss
the well-studied cellular mechanisms leading to the development and progression of diabetic
complications. In addition, we also highlight the various therapeutic paradigms currently in clinical
practice.