Emerging Concepts in the Pathophysiology of Type 2 Diabetes Mellitus

Surampudi, Prasanth; John-Kalarickal, Jennifer; Fonseca, Vivian

doi:10.1002/msj.20113

Cited by 45 publications

(37 citation statements)

References 91 publications

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“…IR is a subnormal biological response to a given concentration of insulin [87] in adipose, muscle, and liver cells [68]. This, for instance, results in the overproduction of glucose by the liver despite fasting hyperinsulinaemia and hyperglycaemia [87]. It has been suggested that adipose tissues play a role in the development of inflammation and the elevation of plasma free fatty acids (FFAs) in obese subjects, which appear to contribute to IR [68].…”

Section: Pathogenesismentioning

confidence: 99%

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Type 2 diabetes mellitus and obesity in sub‐Saharan Africa

Tuei

Maiyoh

2010

Diabetes Metabolism Res

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While communicable diseases such as human immunodeficiency virus/acquired immune deficiency syndrome, malaria, and tuberculosis have continued to pose greater threats to the public health system in sub-Saharan Africa (SSA), it is now apparent that non-communicable diseases such as diabetes mellitus are undoubtedly adding to the multiple burdens the peoples in this region suffer. Type 2 diabetes mellitus (T2DM) is the most common form of diabetes (90-95%), exhibiting an alarming prevalence among peoples of this region. Its main risk factors include obesity, rapid urbanization, physical inactivity, ageing, nutrition transitions, and socioeconomic changes. Patients in sub-Saharan Africa also show manifestations of beta-cell dysfunction and insulin resistance. However, because of strained economic resources and a poor health care system, most of the patients are diagnosed only after they have overt symptoms and complications. Microvascular complications are the most prevalent, but metabolic disorders and acute infections cause significant mortality. The high cost of treatment of T2DM and its comorbidities, the increasing prevalence of its risk factors, and the gaps in health care system necessitate that solutions be planned and implemented urgently. Aggressive actions and positive responses from well-informed governments appear to be needed for the conducive interplay of all forces required to curb the threat of T2DM in sub-Saharan Africa. Despite the varied ethnic and transitional factors and the limited population data on T2DM in sub-Saharan Africa, this review provides an extensive discussion of the literature on the epidemiology, risk factors, pathogenesis, complications, treatment, and care challenges of T2DM in this region.

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Section: Pathogenesismentioning

confidence: 99%

Section: Pathogenesismentioning

confidence: 99%

Type 2 diabetes mellitus and obesity in sub‐Saharan Africa

Tuei

Maiyoh

2010

Diabetes Metabolism Res

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“…The increased risk of cardiovascular events appears to be related to a large number of factors, including hyperactivation of the reninangiotensin-aldosterone system (RAAS), 1 direct vascular damage caused by hyperglycemia in diabetics, 2 systemic subclinical inflammation, 3 aberrant modulation of adipokine synthesis 4 and a pathological increase in the vascular remodeling rate. 5 Angiotensin II (Ang II), the major actor of the RAAS, acts through two receptor subtypes: Ang II type 1 (AT1R) and type 2 (AT2R).…”

Section: Introductionmentioning

confidence: 99%

Different actions of losartan and ramipril on adipose tissue activity and vascular remodeling biomarkers in hypertensive patients

et al. 2010

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We planned a randomized, double blind clinical trial to evaluate whether an antihypertensive intervention at the proximal or distal level of the renin-angiotensin-aldosterone system could have different effects on a broad range of innovative cardiovascular risk biomarkers. A total of 288 hypertensive Caucasian patients (115 men and 113 women), aged X18 years, were enrolled in this study. They were randomized to take losartan 50 mg per day or ramipril 5 mg per day for 1 month and titrated up to 100 mg per day and 10 mg per day for 13 months, respectively. At baseline, 1, 2 and 14 months after therapy initiation, we evaluated the following parameters: body weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), M-value, adiponectin (ADN), resistin (r), retinol binding protein-4 (RBP-4), visfatin, vaspin, high-sensitivity C-reactive protein (Hs-CRP), matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9). No variation of body weight, BMI, FPG or vaspin was obtained with either treatment. We recorded a similar improvement in SBP, DBP and Hs-CRP with both treatments; however, losartan also increased M-value, ADN and visfatin, whereas ramipril did not. Furthermore, losartan decreased r, RBP-4, MMP-2 and MMP-9, whereas ramipril did not have any effect on these parameters. In conclusion, we observed that short-term treatment with losartan improved several metabolic parameters (M-value, ADN, RBP-4, r and visfatin) and decreased vascular remodeling biomarkers (MMP-2 and MMP-9) in hypertensive subjects, whereas ramipril did not.

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“…La diabetes mellitus tipo 2 (DM2) es una enfermedad endocrinológica multifactorial que tiene como manifestación inicial niveles anormalmente elevados de glucosa en sangre, tanto en ayunas como posprandial (1) . Su importancia en salud pública reside en que se constituye como una enfermedad degenerativa crónica que afecta múltiples órganos (ojos, riñones, sistema nervioso periférico y autónomo) siendo la primera causa de ceguera, enfermedad crónica renal terminal y amputaciones en adultos (2) .…”

Section: Introductionunclassified

Efecto hipoglicemiante de los extractos de tabebuia obscura (tahuari oscuro) sobre ratas con diabetes mellitus experimental

Aranda-Ventura¹,

Villacrés²,

Mego³

2016

Rev. per. med. integr.

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Objetivo: Determinar el efecto del extracto acuoso liofilizado de Tabebuia obscura (Bureau & Schumann) Sandwith (TO) (tahuari oscuro) en los valores de glicemia en ratas con diabetes inducida experimentalmente. Materiales y Métodos: Se indujo diabetes experimental con aloxano a 24 ratas macho Holtzman los cuales fueron distribuidos en cuatro grupos de seis ratas cada uno. El grupo I recibió 3 mL de agua destilada (control), Grupo II: Glibenclamida 10 mg/kg (control positivo), Grupo III: Tabebuia obscura 100 mg/kg, Grupo IV: Tabebuia obscura 200 mg/kg. Se determinó la glicemia antes y después de la inducción con aloxano. Luego se evaluo a la 1h, 3h, 6h, 12h y 24h después de administrar las intervenciones. Resultados: Se encontraron diferencias significativas (p<0.05) en los promedios y se encontró correlación lineal en los valores de glicemia de los grupos II, III y IV. El grupo III y el grupo II tuvieron desempeños similares (p=0.456) en lograr disminuir la glicemia; con un coeficiente de correlación intraclase de 0.70. Conclusión: El extracto acuoso liofilizado de Tabebuia obscura en dosis de 100 mg/kg tiene un efecto hipoglicemiante similar a la Glibenclamida a 10 mg/kg en ratas Holtzman macho con diabetes experimental inducida por aloxano.

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Emerging Concepts in the Pathophysiology of Type 2 Diabetes Mellitus

Cited by 45 publications

References 91 publications

Type 2 diabetes mellitus and obesity in sub‐Saharan Africa

Type 2 diabetes mellitus and obesity in sub‐Saharan Africa

Different actions of losartan and ramipril on adipose tissue activity and vascular remodeling biomarkers in hypertensive patients

Efecto hipoglicemiante de los extractos de tabebuia obscura (tahuari oscuro) sobre ratas con diabetes mellitus experimental

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