Many other potential drugs are currently in investigation by pharmaceutical companies. Some of these are simply newer members of one of the above classes, but some work by novel mechanisms. For example, at least one compound that enhances the sensitivity of glucokinase to rising glucose is in the stage of animal research. Others are undergoing phase I/II studies.
- PPARa/? ligands (muraglitazar and tesaglitazar) - development stopped due
to adverse risk profile
- SGLT (sodium-dependent glucose transporter 1) inhibitors increase urinary
glucose.
- FBPase (fructose 1,6-bisphosphatase) inhibitors decrease gluconeogenesis
in liver.
Herbal extracts
The first registered use of anti-diabetic drugs was as herbal extracts used
by Indians in the Amazon Basin for the treatment of type 2 diabetes, and
today promoted as vegetable insulin although not formally an insulin analog.
The major recent development was done in Brazil around Myrcia sphaerocarpa
and other Myrcia species.
"Many countries, especially in the developing world, have a long history of the use of herbal remedies in diabetes (...) STZ diabetic rats were also used to test Myrcia Uniflora extracts (...) ".
The usual treatment is with concentrated (root) Myrcia extracts, commercialized in a 4 US dollar per kilogram packed rocks (~100 times cheaper than equivalent artificial drugs), named "Pedra hume de kaá". Phytochemical analysis of the Myrcia extracts reported kinds of flavanone glucosides (myrciacitrins) and acetophenone glucosides (myrciaphenones), and inhibitory activities on aldose reductase and alpha-glucosidase.
A recent review article presents the profiles of plants with hypoglycaemic properties, reported in the literature from 1990 to 2000 and states that "Medical plants play an important role in the management of diabetes mellitus especially in developing countries where resources are meager."