Modern Concepts of the Pathogenesis of Type 2 Diabetes Mellitus

Abstract

Resume. In Russia, type 2 diabetes affects more than 5 % of the population. Type 2 diabetes accounts for up to 95 % of all cases of diabetes meUitus, but its pathogenetic mechanisms have not yet been fully established. Aim. To summarize and analyze the Literature data on the pathogenetic Links of type 2 diabetes mellitus. Materials and methods. When searching for material for writing a review article, abstract databases PubMed, Google Scholar, e-Library, etc. were used. The search was carried out by publications for the period 1960-2022. The following words and phrases were chosen as parameters for literature selection: pathogenesis of type 2 diabetes mellitus; insulin resistance; endothelial dysfunction; p-cells in type 2 diabetes; inflammation and diabetes, glucose utilization. Results. The article presents the concept of normal glucose metabolism, the role of the loss of functional mass of p-cells, aspects of the synthesis and metabolism of glucose by the liver, the role of muscle tissue in the consumption of glucose, as well as the role of the kidneys in the development of a vicious circle of diabetic hyperglycemia. The role of vascular and myocardial resistance to insulin, adipose inflammation, the "ominous octet" is considered. The place of insulin resistance in the development of obesity was determined, the issues of incretin effects and liver diseases associated with diabetes were raised. Conclusion. The generalized information will expand and deepen knowledge about the pathogenesis of type 2 diabetes mellitus, which, in turn, will serve as a potential basis for new approaches in the treatment of one of the most common diseases of the 21st century.

SGLT2 inhibitors and AMPK: The road to cellular housekeeping?

“…Additionally, it may reduce basal hyperinsulinemia, improve insulin sensitivity, and preserve beta‐cell function and mass. Studies have shown that systemic infusion of AICAR can prevent the development of hyperglycemia and maintain prediabetic beta‐cell mass 7,37 …”