Current and Innovative Molecular Targets in Diabetes Mellitus Therapy: A Systematic Review

Abstract

Diabetes mellitus is a chronic metabolic disorder and a major global health challenge characterized by impaired glucose homeostasis. Although conventional therapies, including insulin and oral hypoglycemic agents such as biguanides and sulfonylureas, remain the cornerstone of treatment, long-term glycemic control is often difficult to achieve because of progressive β-cell dysfunction, insulin resistance, and diabetes-associated complications. This review evaluates current and emerging therapeutic strategies for diabetes management. A focused analysis of conventional pharmacological treatments, novel biological therapies, and molecular targets was conducted to assess their mechanisms, benefits, and limitations. Conventional treatments effectively reduce blood glucose levels but are often limited by adverse effects, secondary failure, and inability to prevent disease progression. Emerging approaches, including incretin-based therapies, stem cell therapy, and gene-based interventions, demonstrate potential for improved glycemic regulation and possible disease modification. Additionally, novel molecular targets such as Transforming Growth Factor Beta (TGF-β) signaling, AMP-activated Protein Kinase (AMPK), and Peroxisome Proliferator-Activated Receptors (PPARs) show promise in enhancing insulin sensitivity, modulating metabolic pathways, and reducing diabetes-related complications. Although conventional therapies remain the cornerstone of diabetes management, their limitations highlight the need for innovative treatment strategies. Targeting key molecular pathways and incorporating advanced biological therapies may improve metabolic control and reduce disease-related complications. Integrating conventional treatments with emerging molecular and regenerative approaches offers a promising strategy for comprehensive and long-term diabetes management. Further clinical studies are needed to establish their safety and therapeutic efficacy.