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Treat liver to beat diabetes
Shivani M Desai1, Avinash P Sanap2, Ramesh R Bhonde3
1Department of Pharmacology, Dr. D. Y. Patil Institute of Pharmaceutical Sciences and Research, Pune, India.
Abstract:
Management of Type 2 Diabetes (T2DM) with existing strategies of life style and pharmaceutical interventions has gained limited success as evidenced by its uncontrolled progression. Two key organs which are involved in pathophysiology of T2DM are liver and pancreas, both are the derivatives of endoderm with common precursor. In the invertebrates, hepatopancreas performs function of both liver and pancreas. It is known that derangement in glycolysis, neoglucogenesis, and glycogenolysis lead to hyperglycemia in T2DM although insulin levels are high. Several studies have reported implication of abnormal liver function in the development of metabolic syndrome i.e. T2DM. Partial hepatectomy has been shown to improve glycemic status in animal models of diabetes. This could be because liver and pancreas share same regenerating factors. These evidences suggest that abnormal liver status can impair pancreatic beta cell function and survival along with peripheral insulin resistance. We therefore hypothesize that restoring deranged liver functions may aid in the better control and management of T2DM. If found true, it may shift current intervention strategy towards liver rather than pancreas in the treatment of T2DM.
Insights
Type 2 Diabetes (T2DM) management shows limited success. This study hypothesizes that restoring liver function, not just pancreas health, may improve glycemic control and T2DM treatment strategies.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Hepatology
Background:
- Type 2 Diabetes Mellitus (T2DM) management using lifestyle and pharmaceuticals has yielded limited success, with disease progression often uncontrolled.
- The liver and pancreas, both endodermal derivatives with a common precursor, are central to T2DM pathophysiology.
- Dysregulation of key metabolic pathways like glycolysis, gluconeogenesis, and glycogenolysis contributes to hyperglycemia, even with elevated insulin levels.
Purpose of the Study:
- To investigate the hypothesis that restoring abnormal liver function can improve glycemic control in Type 2 Diabetes Mellitus.
- To explore the potential of liver-centric interventions for T2DM management.
Main Methods:
- Review of existing literature on T2DM pathophysiology, liver-pancreas interactions, and the effects of liver interventions.
- Analysis of evidence suggesting shared regenerative factors between liver and pancreas.
- Examination of studies linking abnormal liver function to metabolic syndrome and T2DM development.
Main Results:
- Abnormal liver function is implicated in the development of metabolic syndrome and T2DM.
- Partial hepatectomy has demonstrated improved glycemic status in animal models of diabetes.
- Evidence suggests impaired pancreatic beta-cell function and survival, along with insulin resistance, may stem from compromised liver status.
Conclusions:
- Restoring deranged liver functions may offer a novel therapeutic strategy for better Type 2 Diabetes Mellitus control.
- This approach could potentially shift T2DM treatment focus from the pancreas towards the liver.
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