Alterations of Lipid Levels May Induce the Insulin Resistance in Type Two Diabetes Mellitus: A Systemic Review

Abstract

Diabetes mellitus (DM) is not one disorder; it represents a series of metabolic conditions related to hyperglycemia and caused by defects in hormone secretion and hormone action. Exposure to chronic hyperglycemia may result in microvascular complications in the retina (diabetic retinopathy), kidney (diabetic nephropathy), neuron (diabetic-neuropathy), skin, foot, and cardiac complications (stroke, hypertension…etc.). International Diabetes Federation estimates that 1.1 million children and adolescents aged 14–19 years have type one DM. Without interventions to halt the increase in diabetes, there will be at least 629 million people living with diabetes by 2045. In the body, white adipose tissue is the leading site for the storage of excess energy produced from the food intake in large quantities, of the development of insulin resistance (IR) and type 2 DM by the over intake of fatty acid in the body. It results in the accumulation of fatty acyl co-A (FA-CoA) within the myocytes. It leads to improper signaling of the insulin and reduces the level in the myocytes and pancreases beta cells. It combines with genetically reduces the expression of peroxisome proliferator-activated receptor-gamma (PPAR-γ) coactivator-1, initiates the inflammation process by the activation of the tumor necrotic factor alpha and protein kinase C. These alterations lead to further increase the intramyocellular FA-CoA and triglycerides. The sequence of events may develop mitochondrial dysfunction in the sarcolemma outer layers. Finally improves IR also with increasing intramyocellular lipids. This concept might be helpful to those who are pursuing endocrinology specialization, nursing staff, pharmacists, and other medical departments.