Diabetes Mellitus: Mechanistic Frontiers, Novel Biomarkers, and Advances in Pharmacotherapy

This chapter offers a comprehensive review of recent mechanistic discoveries in both type 1 and type 2 diabetes mellitus, including advances in beta-cell biology, islet immunology, insulin resistance pathways, and the gut-brain-pancreas axis. It evaluates the expanding armamentarium of pharmacological agents — GLP-1 receptor agonists, SGLT-2 inhibitors, dual and triple agonists — and contextualizes their mechanisms within current understanding of metabolic disease. Emerging areas including closed-loop insulin delivery systems, beta-cell regeneration, and precision diabetes subclassification are also discussed.