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Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future

Summary Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin affects magnitude of β-cell response. If insulin resistance is present, β cells maintain normal glucose tolerance by increasing insulin ou... Full description

Journal Title: The Lancet (British edition) 2014, Vol.383 (9922), p.1068-1083
Main Author: Kahn, Steven E, Prof
Other Authors: Cooper, Mark E, Prof , Del Prato, Stefano, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Kidlington: Elsevier
ID: ISSN: 0140-6736
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4226760
title: Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future
format: Article
creator:
  • Kahn, Steven E, Prof
  • Cooper, Mark E, Prof
  • Del Prato, Stefano, Prof
subjects:
  • Article
  • Bariatric Surgery
  • Biological and medical sciences
  • Care and treatment
  • clinical trials
  • Development and progression
  • Dextrose
  • Diabetes
  • Diabetes Mellitus, Type 2 - drug therapy
  • Diabetes Mellitus, Type 2 - etiology
  • Diabetes Mellitus, Type 2 - prevention & control
  • Diabetes therapy
  • Diabetes. Impaired glucose tolerance
  • Drug therapy
  • Endocrine pancreas. Apud cells (diseases)
  • Endocrinopathies
  • environment
  • Epigenesis, Genetic
  • Etiopathogenesis. Screening. Investigations. Target tissue resistance
  • Fatty acids
  • Feedback
  • Gene loci
  • Gene-Environment Interaction
  • General aspects
  • Genetic Predisposition to Disease
  • genetics
  • glucagon secretion
  • Glucagon-Secreting Cells - physiology
  • Glucose
  • Glucose - metabolism
  • Humans
  • impaired fasting glucose
  • impaired glucose tolerance
  • inflammation
  • Inflammation - complications
  • Insulin
  • Insulin - metabolism
  • Insulin Resistance
  • insulin secretion
  • Insulin-Secreting Cells - metabolism
  • Insulin-Secreting Cells - physiology
  • Internal Medicine
  • Lifestyles
  • Medical colleges
  • Medical research
  • Medical sciences
  • medications
  • Medicine, Experimental
  • microbiome
  • Obesity
  • Obesity - complications
  • Obesity - surgery
  • Pancreatic beta cells
  • Pathogenesis
  • pathophysiology
  • Physiological aspects
  • prevention
  • Surgery
  • treatment
  • Type 2 diabetes
  • α-cell
  • β cell
ispartof: The Lancet (British edition), 2014, Vol.383 (9922), p.1068-1083
description: Summary Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin affects 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 sufficient 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 effective therapies to slow progressive loss of β-cell function are needed. Recent findings from clinical trials provide important information about methods to prevent and treat type 2 diabetes and some of the adverse effects 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 effects of this disease.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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descriptionSummary Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin affects 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 sufficient 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 effective therapies to slow progressive loss of β-cell function are needed. Recent findings from clinical trials provide important information about methods to prevent and treat type 2 diabetes and some of the adverse effects 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 effects of this disease.
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subjectArticle ; Bariatric Surgery ; Biological and medical sciences ; Care and treatment ; clinical trials ; Development and progression ; Dextrose ; Diabetes ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - etiology ; Diabetes Mellitus, Type 2 - prevention & control ; Diabetes therapy ; Diabetes. Impaired glucose tolerance ; Drug therapy ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; environment ; Epigenesis, Genetic ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Fatty acids ; Feedback ; Gene loci ; Gene-Environment Interaction ; General aspects ; Genetic Predisposition to Disease ; genetics ; glucagon secretion ; Glucagon-Secreting Cells - physiology ; Glucose ; Glucose - metabolism ; Humans ; impaired fasting glucose ; impaired glucose tolerance ; inflammation ; Inflammation - complications ; Insulin ; Insulin - metabolism ; Insulin Resistance ; insulin secretion ; Insulin-Secreting Cells - metabolism ; Insulin-Secreting Cells - physiology ; Internal Medicine ; Lifestyles ; Medical colleges ; Medical research ; Medical sciences ; medications ; Medicine, Experimental ; microbiome ; Obesity ; Obesity - complications ; Obesity - surgery ; Pancreatic beta cells ; Pathogenesis ; pathophysiology ; Physiological aspects ; prevention ; Surgery ; treatment ; Type 2 diabetes ; α-cell ; β cell
ispartofThe Lancet (British edition), 2014, Vol.383 (9922), p.1068-1083
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descriptionSummary Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin affects 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 sufficient 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 effective therapies to slow progressive loss of β-cell function are needed. Recent findings from clinical trials provide important information about methods to prevent and treat type 2 diabetes and some of the adverse effects 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 effects of this disease.
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abstractSummary Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin affects 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 sufficient 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 effective therapies to slow progressive loss of β-cell function are needed. Recent findings from clinical trials provide important information about methods to prevent and treat type 2 diabetes and some of the adverse effects 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 effects of this disease.
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