Weight loss critical in diabetes management.
In a commentary that appeared recently in the Journal of the American Medical Association, (1) Dr. Unger noted that the current paradigm regarding type 2 diabetes focuses on patients' high blood sugar levels, and involves treatments designed to reduce blood sugar, often through intensive insulin therapy. But insulin resistance and the failure of pancreatic beta cells to produce adequate insulin are the result of lipotoxicity, or fatty acid poisoning, according to a new view of the disease. (2)
Fat cells release substances that contribute to insulin resistance, including adiponectin, resistin, tumor necrosis factor-alpha, and interleukin-6. (3) The logical remedy is to reduce or remove the problem--excess body fat--rather than escalate insulin doses. High levels of insulin only contribute to the problem, says Dr. Unger, by shifting excess glucose to fatty acid production, thus increasing the fatty acids that cause diabetes in the first place.
(1.) Unger RH. Reinventing type 2 diabetes: pathogenesis, treatment, and prevention. JAMA. 2008 Mar 12;299(10):1185-7.
(2.) Carpentier AC. Postprandial fatty acid metabolism in the development of lipotoxicity and type 2 diabetes. Diabetes Metab. 2008 Apr;34(2):97-107.
(3.) Keller U. From obesity to diabetes. Int J Vitam Nutr Res. 2006 Jul;76(4):172-7.
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|Title Annotation:||IN THE NEWS|
|Article Type:||Brief article|
|Date:||Aug 1, 2008|
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