Pathogenesis of Type 2 Diabetes Mellitus

Research output: Chapter in Book/Report/Conference proceedingChapter

14 Scopus citations

Abstract

Type 2 diabetes is characterized by multiple pathophysiologic abnormalities which collectively have been referred to as the Ominous Octet:Muscle insulin resistance → reduced glucose uptakeHepatic insulin resistance → excessive glucose productionAdipocyte insulin resistance → accelerated lipolysis and elevated circulating levels of FFA and insulin-resistance provoking adipocytokinesProgressive β-cell failure and apoptosisIncreased alpha cell secretion of glucagon and increased hepatic sensitivity to glucagonReduced incretin effect due to beta cell resistance to GLP-1 and GIPIncreased renal glucose productionElevated renal tubular glucose reabsorptionBrain insulin resistance and altered neurotransmitter dysfunction leading to impaired appetite suppression and weight gain.Insulin resistance in muscle and liver are the earliest detectable abnormalities in the natural history of type 2 diabetes.With time, progressive β-cell failure ensues and, in the presence of insulin resistance, individuals progress from normal glucose tolerance to impaired glucose tolerance to overt type 2 diabetes.

Original languageEnglish (US)
Title of host publicationEndocrinology (Switzerland)
PublisherSpringer Science and Business Media Deutschland GmbH
Pages181-253
Number of pages73
DOIs
StatePublished - 2018

Publication series

NameEndocrinology (Switzerland)
ISSN (Print)2510-1927
ISSN (Electronic)2510-1935

Keywords

  • Beta cell failure
  • Insulin resistance
  • Liver, muscle, adipocyte
  • Ominous octet
  • Pathophysiology of T2DM

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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