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The Metabolic Syndrome pp 343–372Cite as

The Liver, Glucose Homeostasis, and Insulin Action in Type 2 Diabetes Mellitus

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Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Diabetes, and in particular type 2 diabetes (T2DM), is considered clinically unequivocal when fasting hyperglycemia supervenes. However, it has long been clear that this is a final manifestation of a process that has evolved over a long period of time, perhaps even from early fetal development (1). More proximally, fasting hyperglycemia is preceded by impaired glucose tolerance (2). These lesions in tum are foreshadowed by a variety of cellularlbiochemical abnormalities (deviations) that can be detected in subjects (or animal models) who are at risk for the development of diabetes. It has been noted that if science had focused on lipid instead of glucose metabolism in addressing the etiology of diabetes, a similar spectrum of deficiencies would have been detected in these pathways (3). Similarly, early lesions in insulin secretion have also been described by a number of investigators (e.g., 4–6). This serves to point out, not the difficulty of the detection of the first step in the development of diabetes, but rather the (network of) linkages that exist between all aspects of metabolism at the systemic level.

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Authors and Affiliations

  1. University of Ottawa Health Research Institute, Ottawa, Ontario, Canada

    Jerry Radziuk MD, PhD (Director of Diabetes Research and Professor of Medicine) & Susan Pye

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  1. Jerry Radziuk MD, PhD
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  2. Susan Pye
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Editors and Affiliations

  1. Obesity, Diabetes, and Aging Research Center, University of South Florida College of Medicine, Tampa, FL

    Barbara Caleen Hansen PhD (Professor of Internal Medicine and Pediatrics Director) (Professor of Internal Medicine and Pediatrics Director)

  2. Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA

    George A. Bray MD (Boyd Professor) (Boyd Professor)

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Radziuk, J., Pye, S. (2008). The Liver, Glucose Homeostasis, and Insulin Action in Type 2 Diabetes Mellitus. In: Hansen, B.C., Bray, G.A. (eds) The Metabolic Syndrome. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-60327-116-5_18

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  • DOI: https://doi.org/10.1007/978-1-60327-116-5_18

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