CONTEMPORARY DRIFTS IN DIABETES MANAGEMENT Review Article SHRUBAWATI SARKAR 1 , SOUMOK SADHU 2 , RUPAK ROY 3 , SAMBIT TARAFDAR 4 , NABANITA MUKHERJEE 6,7 , MOUMITA SIL 6 , ARUNAVA GOSWAMI 6 , NITHAR RANJAN MADHU 5* 1 Department of Zoology, Derozio Memorial College, Rajarhat, West Bengal, India, 2 Department of Molecular Biosciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Scotland, 3 SHRM Biotechnologies Pvt Ltd., Humaipur, Madhyamgram, West Bengal, India, 4 Amity Institute of Virology and Immunology, Amity University, Noida, India, 5 Department of Zoology, Acharya Prafulla Chandra College, New Barrackpore, Kolkata 700131, West Bengal, India, 6 Agricultural and Ecological Research Unit, Biological Science Division, Indian Statistical Institute, 203 B. T. Road, Kolkata 700108, India, 7 Centre for Research in Nanoscience and Nanotechnology, University of Calcutta, West Bengal, India Email: nithar_1@yahoo.com Received: 10 Nov 2022, Revised and Accepted: 23 Jan 2023 ABSTRACT Diabetes mellitus is a cumulative effect of various cellular and biochemical malfunctions which trigger the blood glucose level far beyond the normal range. From 1980 to 2014, more than 314 million individuals had diabetes. Epidemiology states that it is becoming more prevalent in low-income, middle-income, more specifically, third-world countries than the first-world countries. It showed mortality rate increased by 5% in premature ages. It was the 9 th leading reason for almost 1.5 million deaths. The diagnosis clearly suggests the replacement of insulin-producing pancreatic endocrine cells. Stem cell treatment substitutes the infected or destroyed cells from pluripotent stem cells or multipotent stem cells. One of the favourite ways to understand and treat diabetes mellitus is embryonic stem cells, including pluripotent cells. The in vitro demonstration of iPSC-derived pancreatic cells for treating infection is a grizzled dream of scientists. Luckily, iPSC-derived cells combat the major problems that arose in this field and still, there are no legal and ethical bindings as well as immunological rejections. Later, the β cell of the pancreas has derived from PSCs from various patients who have diabetes. The study proves there is a wide possibility of demonstrating and rectification of clinical administration of these newly developing trends. The use of stem cell therapy in vitro, which is explicit patient research, shows various concerns related to the pathophysiology of diabetes. Successful application of procedures of screening of the apoptosis of β-cells from inbuilt cell retrieval needed to be a proper arrangement of new cell lines. Keywords: β-cells, Insulin, Nanotechnology, Diabetes mellitus, Stem cell therapy © 2023 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/) DOI: https://dx.doi.org/10.22159/ijap.2023v15i2.46792. Journal homepage: https://innovareacademics.in/journals/index.php/ijap INTRODUCTION Diabetes is of two types, namely diabetes mellitus and diabetes insipidus. Sources specify that ancient Indians, Egyptians, and Greeks knew about this disease. The Latin word “Mellitus” means sweet and the Greek word “Mellitus” defines sweetness, as honey is called “Mellita”. Greeks noted that people suffering from such lesions excrete sweet urine as they used to taste the patient’s urine for diagnosis. The patient used to show tendencies to drink excessive water, which could not remain in their body for a very long period. The immediate excretion was demonstrated as siphoning, which was studied as “Diabetes”. In the Indian subcontinent, the “Madhumeha” name was famous as the physicians noticed patients’ urine enchanted ants, flies, and other insects. So, clinically these were the primitive tests to identify glucose in patients [1]. In Africa, almost 5.1% of individuals from the sub-Saharan region have diabetes. In the Caribbean and North American regions, the percentile is 11.4. This state of affairs is about to strike 8.3% of grown-up individuals aged from 20 to 79 worldwide. Third-world countries or low-income countries follow the WHO STEP wise approach to surveillance (popularly known as STEPS) tool, which was launched in 2005, whereas countries of the first world do not follow these properly. Proper lifestyle, Basal Metabolic Rate, blood pressure, and waist circumference are very important risk factors demonstrated by WHO with STEPS. FPG, along with OGTT, is advised to conduct nationwide. BMP type-1 receptor inhibitors, namely dorsomorphin and retinoic corrosive, could be the effective treatment that enhances the differentiation into PDX1 positive β- cells [2, 3]. A small molecule called Indolactum V is isolated, which initiates the differentiation of PDX1-positive cells from hESCs. The ministration of these kinds of cells is administered with SB431542, which is a TGFβ type 1 receptor. Hence this takes action on their differentiation from NGN3-positive precursor cells of the pancreas. Medications with tetrabenazine and reserpine inhibit the vesicular monoamine 2, separating PDX1 responsive cells into NGN3 responsive ancestors. For the ultimate step, these potentially separate pancreatic β-cells [4]. Pathology of diabetes Initially, diabetes was characterized by unrestrained thirst, halitosis (a clinical term for bad odour in breath), profuse urination, presence of sugar or sweetness in urine. Back then, the biochemical pathways of diabetes were unknown to physicians. Statistical investigation shows that about 60% of the mass is distressed by diabetes. Patients who are suffering from it chronically may show various syndromes of hyperosmolar glycemia and diabetic ketoacidosis (DKA) [5]. Blurred vision, loss of vision, and floating dark strings, the red flag of diabetic retinopathy, may also occur. Acute diabetes affects the functional unit of the kidney (nephron), as a result, its function is impaired, and proteins are leaked into the urine, which is clinically termed diabetic nephropathy. In the United States, diabetes is the prime key to peripheral neuropathy. People suffering from diabetes mellitus type-2 have a high risk of segmental bone injury. The prime regulating factor of the biochemical pathway of diabetes is insulin, which plays a pivotal role. The absence or imprudent quantity of this hormone produces diverse corporeal abnormalities and collateral damage in the body. The surplus in body weight and insufficient physical exertion leads to non-insulin-dependent diabetes, popularly called diabetes mellitus type-2. In this case, the body becomes incompetent to the effect of insulin. More than 95% of the human population has diabetes, suffering from non-insulin-dependent diabetes mellitus (NIDDM). Insulin is produced and released by the β-cells of the pancreas [6]. In an auto-immune disease where β-cells are destroyed, insulin production will be halted. In chronic pancreatitis, the cells of this organ become inefficient in producing insulin which regulates blood sugar levels. The illegitimate modification in insulin receptors also plays a crucial role as it is also responsible for insulin- dependent diabetes mellitus (IDDM), which is widely known as International Journal of Applied Pharmaceutics ISSN- 0975-7058 Vol 15, Issue 2, 2023