Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Over the years, pharmacological management of diabetes has expanded from conventional insulin and sulfonylurea therapy to advanced incretin-based therapies and renal glucose-targeting agents. This review evaluates the pharmacological agents used in the management of Type 1 and Type 2 Diabetes Mellitus with respect to their mechanisms of action, clinical efficacy, and safety profiles. A systematic search of published literature was conducted from 1990 to 2024 using electronic databases. Studies discussing insulin therapy, biguanides, sulfonylureas, meglitinides, thiazolidinediones, alpha-glucosidase inhibitors, DPP-4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors, bile acid sequestrants, dopamine agonists, and teneligliptin were included for analysis. The findings suggest that modern diabetes therapy requires individualized treatment strategies depending on disease progression and patient profile. Metformin remains the first-line drug, while incretin-based and SGLT2 inhibitor therapies offer additional metabolic and organ-protective benefits.
Madan et al. (2026) studied this question.