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April 10, 2026Journal of Endocrinology and MetabolismOpen Access

Key Physiopathological Pathways and Emerging Therapeutic Strategies in Type 2 Diabetes Mellitus

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Why the study?

The review aimed to examine molecular cross-talk among the RAS, antioxidant pathway, inflammation, and vitamin D signaling in T2DM pathogenesis to clarify how their interactions drive disease and support mechanism-based therapies.

Design

Review

Key result

Dysregulation of the renin-angiotensin system, oxidative stress, chronic inflammation, and vitamin D signaling pathways interact to drive insulin resistance and complications in type 2 diabetes.

Authors

KAK.K. AwasthiPSPratyush SinghASAshwin Kumar Shukla

Discussion

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Overview

Should not yet alter clinical T2DM management; extends mechanistic understanding of disease progression to inform future targeted.

Key Points

  • The review aims to clarify the interactions among key molecular pathways involved in type 2 diabetes mellitus (T2DM) pathogenesis.
  • Overview of metabolic disorder mechanisms
  • Analysis of RAS and antioxidant pathways
  • Examination of inflammation and vitamin D signaling
  • Discussion of therapeutic strategies targeting these pathways
  • Insulin resistance and β-cell dysfunction are driven by dysregulation of RAS, oxidative stress, inflammation, and vitamin D signaling.
  • Therapeutic interventions show promise but vary in effectiveness based on disease stage and biological factors such as sex.
  • The review identifies potential limitations and adverse effects of current treatments.

Structured PICO

P
Population
Patients with Type 2 diabetes mellitus (T2DM)
I
Intervention
Therapeutic strategies targeting interconnected mechanisms (including ACE inhibitors, ARBs, GLP-1 receptor agonists, SGLT2 inhibitors, DPP-4 inhibitors, antioxidants, metformin, and vitamin D)

The review elucidates the molecular cross-talk among RAS, oxidative stress, inflammation, and vitamin D signaling in T2DM, supporting the development of precise, mechanism-based therapeutic strategies.

Limitations

  • Treatment responses may vary by biological factors such as sex and disease stage
  • Need for well-designed clinical trials to enable precise, mechanism-based management

Cite This Study

Awasthi et al. (2026) conducted a review in Type 2 Diabetes Mellitus. Dysregulation of the renin-angiotensin system, oxidative stress, chronic inflammation, and vitamin D signaling pathways interact to drive insulin resistance and complications in type 2 diabetes.

synapsesocial.com/papers/69d895d86c1944d70ce06eabhttps://doi.org/10.14740/jem1622
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