The Effects of Adipose Tissue Dysregulation on Type 2 Diabetes Mellitus

Internationally, the prevalence of type 2 diabetes mellitus (T2DM) and obesity rates are increasing significantly. As these epidemics continue to spread, the continuation of further research is paramount given that chronic diseases, such as T2DM, cause strain on both economies and healthcare systems. Recently, adipose tissue has been identified as an endocrine organ that produces many hormones that influence many bodily processes. Adipose tissue dysregulation (ATD)-when adipokines (adipose tissue hormones) are produced in abnormal amounts-plays an important role in T2DM development, progression, and prognosis. This narrative review focuses on mechanisms linking ATD with T2DM through adipokine actions (specifically, leptin and adiponectin) on insulin resistance and glucose metabolism. Here we show that the adipokines leptin and adiponectin are valuable in monitoring, diagnosing, and treating diseases. Further, their ratio (the leptin-to-adiponectin ratio, or LAR) may be more valuable than either adipokine individually. The LAR may give researchers the ability to utilize a primary prevention approach by utilizing LAR as a biomarker influencing early prognosis and treatment. Targeting ATD through diet, weight loss, physical activity, etc., may improve prevention and management outcomes for patients living with or at risk of T2DM.