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Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
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Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
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Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...

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Phosphorus-31 Magnetic Resonance Spectroscopy: A Tool for Measuring In Vivo Mitochondrial Oxidative Phosphorylation Capacity in Human Skeletal Muscle
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Metabolic dysfunction in diabetic offspring: deviations in metabolic flexibility.

Ryan D Russell1, Robert R Kraemer, Arnold G Nelson

  • 1Department of Kinesiology, Louisiana State University, Baton Rouge, LA, USA. rrussell@medicine.umaryland.edu

Medicine and Science in Sports and Exercise
|July 20, 2012
PubMed
Summary

Family history of type 2 diabetes (T2D) is linked to metabolic inflexibility, even without impaired blood glucose control. Passive stretching (PS) reveals early mitochondrial dysfunction in those with a family history of T2D.

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Area of Science:

  • Metabolic physiology
  • Endocrinology
  • Mitochondrial function

Background:

  • Type 2 diabetes (T2D) is characterized by insulin resistance, lipotoxicity, poor glucoregulation, and reduced metabolic flexibility.
  • A key debate in T2D research is whether metabolic inflexibility precedes or follows insulin resistance.

Purpose of the Study:

  • To investigate if a family history of T2D (FH+) predisposes individuals to metabolic inflexibility.
  • To identify early markers of metabolic dysfunction in individuals with a family history of T2D.

Main Methods:

  • Compared metabolic characteristics of individuals with T2D, FH+, and controls (FH-) using a metabolic cart.
  • Assessed metabolic responses at rest, during passive stretching (PS) with recovery, and after an oral glucose load.
  • Measured expired gas and blood glucose (BG) levels under fasting conditions.

Main Results:

  • Passive stretching (PS) reduced blood glucose (BG) in FH- and FH+ groups more than in the T2D group.
  • Carbohydrate (CHO) use increased with PS across all groups, notably in the T2D group.
  • Metabolic flexibility during an oral glucose load showed no difference between FH- and T2D groups, but differed between FH- and FH+ groups.

Conclusions:

  • Passive stretching (PS) enhances glycolytic activity in T2D without altering BG, suggesting its utility in assessing metabolic flexibility.
  • Reductions in metabolic flexibility are present in both T2D and FH+ individuals.
  • The FH+ group exhibits early-stage mitochondrial dysfunction without glucoregulatory impairment, indicating metabolic inflexibility precedes overt T2D symptoms.