## 4 Treatment Advancements
### Diabetes Treatments
These drops bypass the digestive system and enter the bloodstream directly, potentially offering a quicker and more convenient alternative to injections for post-meal glucose control [94; 95]. _Nano-carrier encapsulated insulin:_ Another promising approach involves encapsulating insulin in microscopic carriers designed to protect it from stomach acid and deliver it effectively to the liver. This method holds promise for sustained insulin release, potentially mimicking the action of long-acting injectable insulin [96; 97]. Glucose-responsive insulin tabletsThese novel tablets exhibit a glucose-responsive release profile, delivering insulin only in response to elevated blood sugar levels. This approach achieves two key functionalities: overcoming intestinal epithelial barriers and acidic environments, as well as achieving the on-demand release of insulin only in response to rising blood sugar levels. A single dose of insulin delivered by this method significantly extended the therapeutic efficacy up to 16 h in a T1D mouse model [98]. These are just a few examples of ongoing research on oral insulin delivery. While challenges remain, such as ensuring sufficient absorption and controlled release, these advancements offer a glimpse into the future of diabetes management. **Beyond Insulin Therapy:** new classes of medications are emerging, such as sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists, offering alternative mechanisms for blood sugar control. _SGLT2 inhibitors:_ These have emerged as a cornerstone therapy for T2D, demonstrating efficacy in glycemic control and offering a unique safety profile. However, recent advancements have unveiled a broader spectrum of benefits, extending their therapeutic impact beyond blood sugar management. SGLT2 inhibitors have shown effectiveness in lowering blood sugar levels and have even been demonstrated to offer additional benefits, such as reducing the risk of heart failure and kidney disease in individuals with type 2 diabetes [99; 100; 101]. While SGLT2 inhibitors offer a multitude of benefits, it is crucial to acknowledge their limitations. These agents are not a one-size-fits-all solution for T2D management. Potential side effects, such as urinary tract infections and diabetic ketoacidosis, require careful monitoring and patient education [99; 103]. _GLP-1 Receptor Agonists:_ Similar to their role in treating obesity, GLP-1 receptor agonists are emerging as promising treatments for type 2 diabetes. These medications stimulate the release of GLP-1, a gut hormone that promotes insulin secretion, reduces glucagon secretion (which raises blood sugar), and slows down stomach emptying. Clinical trials have shown promising results for improved blood sugar control and weight management in patients with type 2 diabetes [104; 105; 106]. _Dual and triple incretian agonists:_ These medications combine the benefits of GLP-1 receptor agonists with another incretein hormone, GIP (glucose-dependent insulinotropic polypeptide), potentially offering enhanced glycemic control and additional benefits like improved gut health and a reduced risk of hypoglycemia [107; 108; 109]. **Emerging technologies:** The future of diabetes management gleams with promise, with continuous advancements in sensor technology and AI-powered algorithms paving the way for a future free from constant monitoring and toward proactive interventions. _Continuous Glucose Monitoring (CGM):_ This technology offers a significant leap forward in blood sugar monitoring. Instead of relying on finger picks and sporadic blood sugar checks, CGM systems utilize a tiny sensor inserted under the skin to continuously monitor blood sugar levels in real-time. This continuous data stream provides a more comprehensive picture of glucose fluctuations throughout the day and night, allowing for better management of blood sugar levels and the identification of patterns that might otherwise go unnoticed [110; 111].