@inbook{3819c6640955405c9b0b5279cd250225,
title = "Pathogenesis of Type 2 Diabetes Mellitus",
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.",
keywords = "Beta cell failure, Insulin resistance, Liver, muscle, adipocyte, Ominous octet, Pathophysiology of T2DM",
author = "DeFronzo, {Ralph A.}",
note = "Publisher Copyright: {\textcopyright} 2018, Springer International Publishing AG, part of Springer Nature.",
year = "2018",
doi = "10.1007/978-3-319-45015-5_8",
language = "English (US)",
series = "Endocrinology (Switzerland)",
publisher = "Springer Science and Business Media Deutschland GmbH",
pages = "181--253",
booktitle = "Endocrinology (Switzerland)",
address = "Germany",
}