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Related Concept Videos

Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Type II Diabetes II: Pathophysiology01:24

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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 II Diabetes I: Introduction01:26

Type II Diabetes I: Introduction

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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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Carbohydrate Metabolism01:36

Carbohydrate Metabolism

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Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
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Diabetes: Management and Pharmacotherapy01:15

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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
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Type I Diabetes II: Pathophysiology01:26

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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...
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Related Experiment Video

Updated: May 5, 2026

Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test OGTT and Insulin Tolerance Test ITT
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Changing paradigms in type 2 diabetes mellitus.

Romesh Khardori1

  • 1Department of Medicine, Division of Endocrinology and Metabolism, Strelitz Center for Diabetes, Endocrine and Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA 23510, USA.

Indian Journal of Endocrinology and Metabolism
|November 20, 2013
PubMed
Summary

Diabetes mellitus prevalence is rising, necessitating new therapeutic approaches. Revisiting the role of glucagon alongside insulin may offer more effective diabetes treatment by addressing a bi-hormonal defect.

Keywords:
glucagonhypothalamusinsulinislet massliverβ-cell

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Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Diabetes Research

Background:

  • Diabetes mellitus presents a growing global health challenge with significant economic impact.
  • Current understanding of diabetes pathogenesis largely follows a 'two-hit' model: insulin resistance followed by beta-cell failure.
  • Existing therapies based on this model have shown limited success in managing the chronic, progressive nature of the disease.

Purpose of the Study:

  • To advocate for a re-evaluation of islet pathology in diabetes.
  • To propose incorporating the role of glucagon into diabetes treatment strategies.
  • To shift focus from a singular 'insulinopathy' to a 'bi-hormonal defect' model for improved therapeutic outcomes.

Main Methods:

  • This is a review and conceptual discussion.
  • Analysis of existing literature on diabetes pathogenesis and therapy.
  • Synthesis of evidence supporting the role of glucagon in islet dysfunction.

Main Results:

  • The traditional 'two-hit' theory of diabetes may be insufficient for comprehensive treatment.
  • Glucagon plays a critical, yet often overlooked, role in the progression of diabetes.
  • A bi-hormonal defect, involving both insulin and glucagon, is proposed as a more accurate representation of islet pathology.

Conclusions:

  • Rethinking islet pathology to include the bi-hormonal defect is crucial for advancing diabetes therapy.
  • Integrating glucagon's role into treatment regimens could lead to more effective management of diabetes mellitus.
  • Further research and clinical strategies should address the interplay between insulin and glucagon in diabetes.