Diabetes is a major metabolic disease, and the number of patients is still
growing in both industrialized and developing countries. Drugs to reduce blood glucose
levels by several mechanisms have been launched in past decades, and the options for
treating hyperglycemia have been extended. However, it is still difficult to control blood
glucose level strictly, and moreover, current therapies using hypoglycemic agents have
not shown sufficient effect to prevent the development of microvascular complications
that result in impaired quality of life (QOL) of patients. Therefore treatments for these
diabetic complications are urgently needed. Drugs for diabetic peripheral neuropathy
currently in use are mainly for management of diabetic neuropathic pain, and do not
cure the underlying cause of the disease. In diabetic retinopathy, intravitreal injection of
anti-VEGF agents is a current approach, but the administration route is insufficient.
Diabetic nephropathy is treated with angiotensin-I converting enzyme (ACE) inhibitors
and angiotensin-II receptor blockers (ARBs), which were originally prescribed for
hypertension. These situations indicate the lack of effective target-oriented medication
for diabetic compliations, and drugs with novel mechanism should be developed. In this
chapter, we summarize drugs for three major diabetic complications currently in use
and in clinical trial phases. It is hoped this will help the reader to understand the trend of
current pharmacological approaches and the tide of next-generation drugs in this field.
Keywords: ACE inhibitor, analgesia, Anti-VEGF, ARB, ARI, blood circulation
disorder, clinical trials, diabetes, diabetic complications, diabetic macular edema,
diabetic nephropathy, diabetic neuropathy, diabetic retinopathy, metabolic
disorder, microalbuminuria, microvascular complications, new drugs, painful
diabetic neuropathy, RAS inhibitor.
