Type 2 diabetes mellitus (T2DM) is a complex disease that can lead to a variety of life-threatening secondary health conditions. Current treatment strategies primarily revolve around tight glucose control that is difficult to achieve and often turns out to be dangerous due to possible hypoglycemic events. Numerous long-term studies have demonstrated that complex pathways, including low-grade inflammation due to fluctuating glucose levels, are involved in the progression of the disease and the development of secondary health conditions. Growing clinical evidence supports the effectiveness of using multiple medications, possibly in combination with insulin, to effectively manage T2DM. On the other hand, despite the huge, largely untapped potential therapeutic benefit of 'polyphenols', there remains a general skepticism of the practice. However, for any evidence-based clinical intervention, the balance of benefits and risks takes center stage and is governed by biopharmaceutics principles. In this article, we outline the current clinical perspectives on pharmaceutical drug combinations, rationale for early initiation of insulin, and the advantages of novel dosage forms to meet the pathophysiological changes of T2DM, emphasizing the need for further clinical studies to substantiate these approaches. We also make the case for traditional medicines and their combinations with pharmaceutical drugs and outline the inherent challenges in doing so, while also providing recommendations for future research and clinical practice. Significance Statement Type 2 diabetes is associated with life-threatening secondary health conditions that are often difficult to treat. This review provides an in-depth account of preventing/delaying secondary health conditions through combination therapies and emphasizes the role of effective delivery strategies in realizing the translation of such combinations. We will build the case for the importance of polyphenols in diabetes, determine the reasons for skepticism, and potential combinations with pharmaceutical drugs.

中文翻译：

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多酚与 2 型糖尿病药物融合的前景：挑战、风险和策略。


2 型糖尿病 (T2DM) 是一种复杂的疾病，可导致多种危及生命的继发性健康状况。目前的治疗策略主要围绕严格的血糖控制，但这种控制很难实现，而且由于可能发生低血糖事件，往往会带来危险。大量长期研究表明，复杂的途径，包括血糖水平波动引起的低度炎症，与疾病的进展和继发性健康状况的发展有关。越来越多的临床证据支持使用多种药物（可能与胰岛素联合使用）来有效控制 T2DM 的有效性。另一方面，尽管“多酚”具有巨大的、很大程度上尚未开发的潜在治疗益处，但人们仍然普遍对这种做法持怀疑态度。然而，对于任何基于证据的临床干预，利益和风险的平衡占据中心地位，并受生物药剂学原则的约束。在本文中，我们概述了当前药物组合的临床观点、早期开始使用胰岛素的基本原理以及满足 T2DM 病理生理变化的新型剂型的优势，并强调需要进一步的临床研究来证实这些方法。我们还阐述了传统药物及其与药物组合的案例，并概述了这样做的固有挑战，同时还为未来的研究和临床实践提供了建议。意义陈述 2 型糖尿病与危及生命的继发性健康状况有关，而且往往难以治疗。 这篇综述深入阐述了通过联合疗法预防/延迟继发性健康状况，并强调了有效的给药策略在实现此类联合治疗中的作用。我们将论证多酚在糖尿病中的重要性，确定怀疑的原因，以及与药物的潜在组合。