Pathophysiology of Type 2 Diabetes Mellitus and Its Complications Associated with Obesity and Oxidative Stress: Τhe Molecular Mechanisms Involved in Their Management Through the Prism of Various Antioxidant Compounds and Their Potency

Diabetes mellitus (DM) is a complex, heterogeneous, chronic metabolic disorder characterized by persistent hyperglycemia. The most common classification of diabetes includes type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes. The aim of the study is to investigate the underlying mechanisms of T2DM, its clinical presentation, and complications. The association of the pathogenesis of T2DM and the occurrence of its complications with obesity, chronic inflammation, oxidative stress (OS), insulin resistance (IR), hepatic steatosis, dyslipidemia, and molecular pathways, such as NF-κB and JAK/STAT is also summarized, under the scope of the effects of several antioxidant compounds and minerals in their progression. T2DM is characterized by progressive loss of insulin secretion from pancreatic islet β-cells due to IR, which is a parameter of metabolic syndrome (MetS). Chronic hyperglycemia in patients with TDM in synergy with other metabolic abnormalities causes acute complications such as diabetic ketoacidosis, osmotic diuresis and hyperglycemic diabetic coma, chronic microvascular complications such as diabetic retinopathy, nephropathy and neuropathy and macrovascular complications such as atherosclerotic cardiovascular disease (ASCVD), peripheral artery disease (PAD) and cerebrovascular events, which implicate the formation of reactive species and the promotion of inflammatory pathways. In these events natural or synthetic antioxidants and minerals seem to be ameliorating or co-treatment beneficial options. Obese patients are recommended to be screened for T2DM and to make lifestyle changes including exercise, diet modification, and weight loss, potentially together with anti-obesity pharmacotherapy, and multifunctional supplements with antioxidant and anti-inflammatory potential.