Type 2 Diabetes: An Overview

Type 2 diabetes is a heterogeneous disorder. Clinical expression of the disorder requires both genetic and environmental factors. One theory concerning its etiology is that it is the result of the evolution of a thrifty genotype that had survival benefits in the past but is detrimental in the curren...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Md.), 1999-08, Vol.45 (8), p.1339-1345
Main Author: Lebovitz, Harold E
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiovascular Diseases - prevention & control
Diabetes Mellitus, Type 2 - classification
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - etiology
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Humans
Hypoglycemic Agents - therapeutic use
Insulin Resistance
Medical sciences
Obesity - etiology
Risk Factors
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Summary:Type 2 diabetes is a heterogeneous disorder. Clinical expression of the disorder requires both genetic and environmental factors. One theory concerning its etiology is that it is the result of the evolution of a thrifty genotype that had survival benefits in the past but is detrimental in the current environment. An opposing theory is that it represents an adult metabolic response to fetal malnutrition. Hyperglycemia in type 2 diabetes results from absolute or relative insulin deficiency. Most often relative insulin deficiency is attributable to an inability to adequately compensate for insulin resistance. Insulin resistance may be caused by a variety of genetic or metabolic factors. The most common etiological factor in insulin resistance is central obesity. Insulin resistance is associated with a cluster of metabolic abnormalities that include glucose intolerance, hypertension, a unique dyslipidemia, a procoagulant state, and an increase in macrovascular disease. Clinical intervention studies have demonstrated that reduction in the chronic microvascular and macrovascular complications of type 2 diabetes requires treatment of hyperglycemia to achieve hemoglobin A1c
ISSN:0009-9147
1530-8561
DOI:10.1093/clinchem/45.8.1339