PATHOPHYSIOLOGY AND TREATMENT OF TYPE 2 DIABETES: PERSPECTIVES ON THE PAST, PRESENT AND FUTURE
By S. Kahn, M. Cooper, S. Del Prato. The Lancet, 2013
1,571 citations recorded by the source corpus.
Normal regulation of glucose metabolism is determined by a feedback loop involving the islet β-cell and insulin-sensitive tissues in which tissue sensitivity to insulin determines the magnitude of the β-cell response. When insulin resistance is present, the β-cell maintains normal glucose tolerance by increasing insulin output. It is only when the β-cell is incapable of releasing sufficient insulin in the presence of insulin resistance that glucose levels rise. While β-cell dysfunction has a clear genetic component, environmental changes play a vital role. Modern approaches have also informed regarding the importance of hexoses, amino acids and fatty acids in determining insulin resistance and β-cell dysfunction as well as the potential role of alterations in the microbiome. A number of new treatment approaches have been developed, but more effective therapies that slow the progressive loss of β-cell function are needed. Recent clinical trials have provided important information regarding approaches to prevent and treat type 2 diabetes as well as some of the adverse effects of these interventions. However, additional long-term studies of medications and bariatric surgery are required in order to identify novel approaches to prevention and treatment, thereby reducing the deleterious impact of type 2 diabetes.
Subfields: Endocrinology, Diabetes and Metabolism, Molecular Biology, Physiology
View Paper: https://www.semanticscholar.org/paper/396479d41acb51b220886d229e3300d27554b945
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In Endocrinology, Diabetes and Metabolism
Citations in the corpus
- Hepatic Acetyl CoA Links Adipose Tissue Inflammation to Hepatic Insulin Resistance and Type 2 Diabetes (2015, neutral): “Fasting hyperglycemia, due to increased rates of hepatic gluconeogenesis, and the inability of insulin to suppress this process are the hallmark of T2D, but the molecular mechanism for this alteration is unknown (Kahn et al., 2014; Olefsky and Glass, 2010; Robbins et al., 2014; Samuel and Shulman, 2”
- Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors (2020, background): “The guidelines for oncological disease prevention and early detection are based on cancer risk assessment, including past medical history, lifestyle factors, family diseases history, and genetic testing (10).”
- Insulin resistance: Review of the underlying molecular mechanisms (2018, background): “However, a number of mechanisms, including insulin resistance (IR), beta cell dysfunction and apoptosis with lower circulatory insulin levels, oxidative stress, mitochon- drial dysfunction, and inflammation have all been implicated (S. E. Kahn et al., 2014; Zaccardi et al., 2015).”