Type 2 diabetes: principles of pathogenesis and therapy

Review

关键词: ACTIVATED PROTEIN-KINASE;    INDUCED INSULIN-RESISTANCE;    BETA-CELL FUNCTION;    IMPAIRED GLUCOSE-TOLERANCE;    FREE FATTY-ACIDS;    KAPPA-B;    MOLECULAR-MECHANISMS;    GENETIC-VARIATION;    MINIMAL-MODEL;    PPAR-GAMMA;   

DOI  :  10.1016/S0140-6736(05)61032-X

来源: SCIE

【 摘 要 】

Type 2 diabetes mellitus has become an epidemic, and virtually no physician is without patients who have the disease. Whereas insulin insensitivity is an early phenomenon partly related to obesity, pancreas beta-cell function declines gradually over time already before the onset of clinical hyperglycaemia. Several mechanisms have been proposed, including increased non-esterified fatty acids, inflammatory cytokines, adipokines, and mitochondrial dysfunction for insulin resistance, and glucotoxicity, lipotoxicity, and amyloid formation for beta-cell dysfunction. Moreover, the disease has a strong genetic component, but only a handful of genes have been identified so far: genes for calpain 10, potassium inward-rectifier 6.2, peroxisome proliferator-activated receptor gamma, insulin receptor substrate-1, and others. Management includes not only diet and exercise, but also combinations of anti-hyperglycaemic drug treatment with lipid-lowering, antihypertensive, and anti platelet therapy.

【 授权许可】

Free