Deopa et al Journal of Drug Delivery & Therapeutics; 2013, 3(6), 121-126 121 © 2011, JDDT. All Rights Reserved ISSN: 2250-1177 CODEN (USA): JDDTAO Available online at http://jddtonline.info REVIEW ARTICLE CURRENT UPDATES ON ANTI-DIABETIC THERAPY Deopa Deepika *, Sharma Kumar Satish, Singh Lalit Sunder Deep Pharmacy College, Ghaziabad, UP, India- 201001 *Corresponding Author’s E-mail: deepikadeopa1@gmail.com, Mobile: 09999674590 INTRODUCTION Diabetes mellitus is defined by a group of metabolic disorder caused by altered metabolism of carbohydrate, lipid and lipoprotein resulting from the defect in insulin secretion and action; it is characterized by symptom likehyperglycemia, glycosuria, polyphagia, polyurea, polydipsia, gradual loss of weight, fatigue, cramps, blurred vision, constipation, and candidiasis are prominent.It is the most prevalent chronic disease in the world affecting nearly 100 million persons of the population where 5-10% having type 1 while 90-95% of them suffers from type 2 diabetes mellitus.Diabetes leads to many health complications such as hyperlipidemia, hypertension and atherosclerosis 1,2 . Categorization of Diabetes There are mainly four types of diabetes mellitus i.e. Type I diabetes or insulin dependent diabetes mellitus(IDDM),type II diabetes or non insulin dependent diabetes mellitus (NIDDM),the other two diabetes mellitus are not much common i.e. gestational diabetes and genetically modified diabetes 4 . Type I diabetes can occur in any age but priorly seen in young adult. It is an immune mediated disease resulting from destruction in β-cells of pancreas which leads to insufficientendogenous insulin production. Type II diabetes or non insulin dependent diabetes mellitus (NIDDM) is the most common type affecting elderly and obese personcaused either by insulin resistance or deficient insulin secretion.It is characterized by hyperglycemia in the presence of hyperinsulinemia due to peripheral insulin resistance. Type 2 diabetes mellitus is most encountered form of diabetes accounting for more than 80% of total case of diabetes while in western countries it affects 7% of the population in particular 5 .A third type of diabetes GDM (gestation diabetes mellitus) is first recognize during pregnancy where hyperglycemic condition developsin women who doesn’t have diabetes result from an inadequate insulin supply to meet tissue demand for normal blood glucose regulation. Fourth type of diabetes is genetically modified DM there occur defects in β cell function or mutation of insulin receptor and may lead to diabetes. Other rare types of diabetes include those caused by surgery, drug used (e.g. antihypertensive vasodilator diazoxide, corticosteroids in high doses, lower dose of thiazides, oral contraceptives, high dose of anabolic androgens, streptozotocin, alloxan, theophylline, asprin, isoniazid, nalidixic acid ), malnutrition, infection and other illness. 6 Acute and long-term occurrence of type 1 and type 2 diabetes mellitus can result in macrovascular (coronary artery disease, atherosclerosis and peripheral vascular disease) and microvascular (retinopathy, nephropathy, and neuropathy) complications 7 . Chronic hyperglycemia is an important factor leading to complications of DM causing diverse cellular and organ dysfunctionwhich may lead to autonomic dysfunction, potential blindness, renal failure (due to nephropathy), and foot ulcers, amputation, Charcot joints (due to neuropathy). Insulin and its secretion The insulin is a polypeptide hormone having a molecular weight of 6000 Da. It is originally produced as a single molecule (pre-proinsulin) consists of 110 amino acids released by the pancreatic β-cells whichareresponsible for glucose homeostasis. It consists of two polypeptide chains A and B containing 21 and 30 amino acid residue respectively. 8 Two disulfide bridges (residue A 7 to B7 and A20 to B19) covalently bind the chain where chain A containsan internal disulfide bridge (residue A6 to A 11).Hormone insulin is synthesized as pre- proinsulin in rough endoplasmic reticulum further by proteolysis it convert to pro-insulin and then to insulin.The A chain has an amino terminal helix (A1 –A8) linked to an anti-parallel carboxy- terminal helix (A 12-A20). The B chain has a central helix (B8-B19), flanked by extended amino and carbonyl terminal strands. This arrangement is called the T conformation. .After pre-proinsulin has passed through the endoplasmic reticulum, 24 amino acids are removed by enzymatic action from one end of chain, leaving another ABSTRACT Diabetes globally has become one of the chronic public health problems and is related to group of metabolic defects resulting due to defect in insulin secretion and its action. As the disease progress micro and macro vascular damage may lead to retinopathy, neuropathy, nephropathy and various cardiovascular like complications. It is estimated that by the year of 2030 about 439 million adults would be suffering from any form of diabetes. There are mainly two types of diabetes which is because of their occurrence rate. The current review covers the basic aspect of types of diabetes, insulin molecular, chemical basis, and its secretion, hypoglycemic drugs used and their mode of action, what are the recent advancement in terms of new drugs finding, and the herbal plants. Thus, the information will help researchers for development of combination medication which involve both recent medication and herbal medication for combating various complication associated with diabetes. Key-Words: Hyperglycemia, insulin, glucose, phyto-constituents.