Abstract
Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin aff ects magnitude of β-cell response. If insulin resistance is present, β cells maintain normal glucose tolerance by increasing insulin output. Only when β cells cannot release suffi cient insulin in the presence of insulin resistance do glucose concentrations rise. Although β-cell dysfunction has a clear genetic component, environmental changes play an essential part. Modern research approaches have helped to establish the important role that hexoses, aminoacids, and fatty acids have in insulin resistance and β-cell dysfunction, and the potential role of changes in the microbiome. Several new approaches for treatment have been developed, but more eff ective therapies to slow progressive loss of β-cell function are needed. Recent fi ndings from clinical trials provide important information about methods to prevent and treat type 2 diabetes and some of the adverse eff ects of these interventions. However, additional long-term studies of drugs and bariatric surgery are needed to identify new ways to prevent and treat type 2 diabetes and thereby reduce the harmful eff ects of this disease.
| Original language | English |
|---|---|
| Pages (from-to) | 1068-1083 |
| Number of pages | 16 |
| Journal | The Lancet |
| Volume | 383 |
| Issue number | 9922 |
| DOIs | |
| Publication status | Published - Mar 2014 |
| Externally published | Yes |
Cite this
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Pathophysiology and treatment of type 2 diabetes : Perspectives on the past, present, and future. / Kahn, Steven E.; Cooper, Mark E.; Prato, Stefano Del.
In: The Lancet, Vol. 383, No. 9922, 03.2014, p. 1068-1083.Research output: Contribution to journal › Review Article › Research › peer-review
TY - JOUR
T1 - Pathophysiology and treatment of type 2 diabetes
T2 - Perspectives on the past, present, and future
AU - Kahn, Steven E.
AU - Cooper, Mark E.
AU - Prato, Stefano Del
PY - 2014/3
Y1 - 2014/3
N2 - Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin aff ects magnitude of β-cell response. If insulin resistance is present, β cells maintain normal glucose tolerance by increasing insulin output. Only when β cells cannot release suffi cient insulin in the presence of insulin resistance do glucose concentrations rise. Although β-cell dysfunction has a clear genetic component, environmental changes play an essential part. Modern research approaches have helped to establish the important role that hexoses, aminoacids, and fatty acids have in insulin resistance and β-cell dysfunction, and the potential role of changes in the microbiome. Several new approaches for treatment have been developed, but more eff ective therapies to slow progressive loss of β-cell function are needed. Recent fi ndings from clinical trials provide important information about methods to prevent and treat type 2 diabetes and some of the adverse eff ects of these interventions. However, additional long-term studies of drugs and bariatric surgery are needed to identify new ways to prevent and treat type 2 diabetes and thereby reduce the harmful eff ects of this disease.
AB - Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin aff ects magnitude of β-cell response. If insulin resistance is present, β cells maintain normal glucose tolerance by increasing insulin output. Only when β cells cannot release suffi cient insulin in the presence of insulin resistance do glucose concentrations rise. Although β-cell dysfunction has a clear genetic component, environmental changes play an essential part. Modern research approaches have helped to establish the important role that hexoses, aminoacids, and fatty acids have in insulin resistance and β-cell dysfunction, and the potential role of changes in the microbiome. Several new approaches for treatment have been developed, but more eff ective therapies to slow progressive loss of β-cell function are needed. Recent fi ndings from clinical trials provide important information about methods to prevent and treat type 2 diabetes and some of the adverse eff ects of these interventions. However, additional long-term studies of drugs and bariatric surgery are needed to identify new ways to prevent and treat type 2 diabetes and thereby reduce the harmful eff ects of this disease.
UR - http://www.scopus.com/inward/record.url?scp=84896495719&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(13)62154-6
DO - 10.1016/S0140-6736(13)62154-6
M3 - Review Article
VL - 383
SP - 1068
EP - 1083
JO - The Lancet
JF - The Lancet
SN - 0140-6736
IS - 9922
ER -