Pathogenesis of type 2 diabetes: the relative contribution of insulin resistance and impaired insulin secretion.

摘要: Type 2 diabetes is characterised by both impaired insulin secretion and resistance but their relative contribution to the development of hyperglycaemia may differ due heterogeneity disease. Under most circumstances, earliest detectable defect in pre-diabetic individuals it not known whether this primary or secondary other abnormalities such as abdominal obesity with excessive free fatty acid turnover increased lipid deposits muscle. Initially, enhanced can compensate for early phase impaired. In transition from normal diabetic glucose tolerance, sensitivity deteriorates about 40% whereas 3-4 fold. addition resistance, metabolic syndrome includes hypertension, dyslipidaemia, microalbuminuria. patients manifest diabetes, chronic result further deterioration (glucotoxicity), which aggravated elevated acids (lipotoxicity). Abdominal are strongly correlated studies have aimed at understanding genetic basis. Candidate genes include those beta 3-adrenergic receptor, lipoprotein lipase, hormone sensitive peroxisome proliferator-activated receptor-gamma, receptor substrate-1 glycogen synthase. Therefore, type multigenic appears represent a collision between thrifty an affluent society. Successful management will require treatments targeted defects resistance.