Hundred years since insulin discovery: An update on current and future perspectives for pharmacotherapy of Diabetes Mellitus.

Diabetes mellitus was considered a fatal malady till the discovery, extraction and commercial availability of Insulins. Numerous other classes of drugs ranging from sulfonylureas to Sodium-glucose co-transporter-2 inhibitors were then marketed. However, with the prevalence of diabetes mellitus increasing every year, many more drugs and therapies are under investigation. This review article aimed to summarize the significant developments in the pharmacotherapy of diabetes mellitus and outline the progress made by the recent advances, at hundred years since insulins were first extracted successfully. Insulin analogs and Insulin delivery pumps have further improved glycemic control in diabetes mellitus. Cardiovascular and renal outcome trials have changed the landscape of diabetology, with some of these drugs also efficacious in non-diabetics. Newer drug delivery systems are being evaluated to improve the efficacy and reduce the dosing frequency and adverse effects of antidiabetics. Some newer drugs with novel mechanisms of action targeting type 1 and type 2 diabetes have also shown promise in recent clinical trials. These drugs include dual GIP and GLP1 agonists, glucokinase activators, anti-CD3 monoclonal antibodies, glimins, and many more. Their efficacy in larger studies needs to be evaluated.