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Pathophysiology of Type-2 Diabetes

  • Ronald A. Codario
Chapter
Part of the Current Clinical Practice book series (CCP)

Abstract

Appropriate treatment of type-2 diabetes is dependent upon the knowledge of the pathophysiology of the disease, the mechanisms underlying hyperglycemia, and the efficacy of various oral agents and insulins to improve fasting or postprandial hyperglycemia.

Key Words

Glucose Insulin Type-2 diabetes Tissue response Non autoimmune beta cell function Hepatic glucose production Islet alpha cell glucagon secretion Incretins 

References

  1. 1.
    Tuomi T, Carlsson A, Li H. Clinical and genetic characteristics of type-2 diabetes with and without GAD antibodies. Diabetes 1999;48(1):150–157.PubMedCrossRefGoogle Scholar
  2. 2.
    Groop LC. Pathogenesis of insulin resistance in type 2 diabetes: a collision between thrifty genes and an affluent environment. Diabetes Obes Metab I Suppl 1999;1:51–57.Google Scholar
  3. 3.
    Gillies Cl. Different strategies for screening and prevention of type-2 diabetes in adults. BMJ 2008; 336(7654):1180–1185.PubMedCrossRefGoogle Scholar
  4. 4.
    LeRoith D. Beta-cell dysfunction and insulin resistance in type 2 diabetes: role of metabolic and genetic abnormalities. Am J Med 2002;113(suppl 6A):3S–11S.PubMedCrossRefGoogle Scholar
  5. 5.
    Goldstein BJ. Insulin resistance as the core defect in type 2 diabetes mellitus. Am J Cardiol 2002;90:3G–10G.PubMedCrossRefGoogle Scholar
  6. 6.
    Haffner SM. The insulin resistance syndrome revisted. Diabetes Care 1996;19:275–277.PubMedGoogle Scholar
  7. 7.
    Grundy SM. Obesity, metabolic syndrome, and coronary atherosclerosis. Circulation 2002;105:2696–2698.PubMedCrossRefGoogle Scholar
  8. 8.
    Atkinson MA, Maclaren NK. The pathogenesis of insulin-dependent diabetes mellitus. N Engl J Med 1994;331:1428–1436.PubMedCrossRefGoogle Scholar
  9. 9.
    Budzikowski A. Obesity, diabetes, and hypertension: a growing epidemic. Cardiol Rev 2003;20(9):9–10.Google Scholar
  10. 10.
    Narayan KM, Imperatore G, et al. Targeting people with pre-diabetes. BMJ 2002;325:403–404.PubMedCrossRefGoogle Scholar
  11. 11.
    Young TK, et al. Type 2 diabetes mellitus in children: prenatal and early infancy risk factors among native Canadians. Arch Pediatr Adolesc Med 2002;156:651–655.PubMedCrossRefGoogle Scholar
  12. 12.
    Westermark GT, Westermark P. Widespread amyloid deposition in transplanted human pancreatic islets. N Engl J Med 2008;359(9):977–979.PubMedCrossRefGoogle Scholar
  13. 13.
    Jack L, et al. Aging Americans and diabetes. Geriatrics 2004;59(4):14–17.Google Scholar
  14. 14.
    Sobel BE. Insulin resistance and thrombosis. Am J Cardiol 1999;84(1A):37J–41J.PubMedCrossRefGoogle Scholar
  15. 15.
    Shepherd PR, Kahn BB. Glucose transporters and insulin action: implications for insulin resistance and diabetes mellitus. N Engl J Med 1999;341:248.PubMedCrossRefGoogle Scholar
  16. 16.
    Gaede P. Multifactorial intervention and cardiovascular disease in patients with type-2 diabetes. N Engl J Med 2003;348:383.PubMedCrossRefGoogle Scholar
  17. 17.
    Ix J, Wassel C, Kanaya A. Fetuin-A and incident diabetes mellitus in older persons. JAMA 2008;300(2): 182–188. PubMedCrossRefGoogle Scholar
  18. 18.
    Sinha R, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 2002;346:802–810.PubMedCrossRefGoogle Scholar
  19. 19.
    Leahy JL, Bonner-Weir S. Beta cell dysfunction induced by chronic hyperglycemia: current ideas on mechanism of impaired glucose induced insulin secretion. Diabetes Care 1992;15:442.PubMedCrossRefGoogle Scholar
  20. 20.
    Ferrannini E. Insulin resistance versus insulin deficiency in non-insulin dependent diabetes mellitus: problems and prospects. Endocr Rev 1998;19:477.PubMedCrossRefGoogle Scholar
  21. 21.
    Fagan TC, Deedwaqnia PC. The cardiovascular dysmetabolic syndrome. Am J Med 1998;105(suppl 1A):77S–82S.PubMedCrossRefGoogle Scholar
  22. 22.
    Cubeddu LX, Hoffmann IS. Insulin resistance and upper normal glucose levels in hypertension: a review. J Hum Hypertens 2002;16(suppl 1):S52–S55.PubMedCrossRefGoogle Scholar
  23. 23.
    Seely BL, Olefsky JM, Insulin Resistance. David E Mohier, ed. Wiley & Sons Ltd. Publisher 1993;187–252.Google Scholar
  24. 24.
    Deedwania PC. Mechanism of the deadly quartet. Can J Cardiol 2000;16(suppl E):17E–20E.PubMedGoogle Scholar
  25. 25.
    Consensus Report of the American Diabetes Association. Diabetes Care 1998; 21:310–314.Google Scholar
  26. 26.
    Rose G. High risk and population strategies of prevention: ethical considerations. Ann Med 1989; 21:409–413.PubMedCrossRefGoogle Scholar
  27. 27.
    Narayan KM, et al. Lifetime risk for diabetes mellitus in the United States. JAMA 2003;290(14):1884–1890.Google Scholar
  28. 28.
    Harris M. Undiagnosed type 2 diabetes: clinical and public health issues. Diabetes Care 1993;16:643.Google Scholar
  29. 29.
    United Kingdom Prospective Diabetes Study (UKPDS) Group. Intensive blood glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837–853.CrossRefGoogle Scholar

Supplementary Readings

  1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010;33(suppl 1):S62–S69.CrossRefGoogle Scholar
  2. Boden G. Pathogenesis of type 2 diabetes: insulin resistance. Endocrinol Metab Clin North Am 2001;30:801–815.PubMedCrossRefGoogle Scholar
  3. Centers for Disease Control and Prevention. 2007 national diabetes fact sheet. http//www.cdc.gov/diabetes/pubs/factsheet07.htm
  4. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977–986.CrossRefGoogle Scholar
  5. Desai J, Geiss L, Muktar Q, et al. Public health surveillance of diabetes in the United States. J Public Health Manag Pract 2003;Suppl:S44–S51.PubMedGoogle Scholar
  6. Grimble RF. Inflammatory status and insulin resistance. Curr Opin Clin Nutr Metab Care 2002;5:551–559.PubMedCrossRefGoogle Scholar
  7. Kahn BB. Gluocse transport: pivotal step in insulin action. Diabetes 1996;45:1644–1654.PubMedCrossRefGoogle Scholar
  8. Marshall JA, Bessesen DH. Dietary fat and the development of type 2 diabetes. Diabetes Care 2002;25:620–622.PubMedCrossRefGoogle Scholar
  9. Patel P, Macerollo A. Diabetes mellitus: diagnosis and screening. Am Fam Physician 2010;81(7):863–870.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Ronald A. Codario
    • 1
  1. 1.University of Pennsylvania Health System Thomas Jefferson University HospitalPhiladelphiaUSA

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