Mechanisms leading to Type 2 Diabetes
How it goes wrong
Multiple gene defects are felt to cause Type 2 Diabetes. It is not due to a single gene defect. These gene defects in the presence of environmental factors such as a poor diet rich in carbohydrates, and a sedentary lifestyle, predispose to Type 2 Diabetes. If one identical twin develops Type 2 Diabetes, the other twin has almost a 100% chance of developing Type 2 Diabetes.
In Type 2 diabetes, there is increased fasting blood sugar, elevated post-meal blood sugar, insulin resistance, impaired (decreased) insulin secretion, increased glucose production by the liver, increased glucagon (a hormone that causes the release of glucose from the liver).
Even before high blood sugar occurs, insulin resistance and impaired insulin secretion are present.
Other factors contributing to Type 2 Diabetes development are central obesity, sedentary lifestyle, high-fat diet, and aging.
In Type 2 Diabetes, three changes occur.
- Insulin resistance.
- There is a marked decrease in beta-cell function in the pancreas, causing a decline in insulin production. This decrease in secretion is probably a genetic abnormality or acquired defect due to glucose toxicity or beta-cell exhaustion, or both.
- Glucose output from the liver increases
NOTE: Insulin resistance is when the insulin is not as effective as usual on the insulin receptors (present in the cells). Insulin resistance is genetic in origin, worsened by a sedentary lifestyle. The beta cells in the pancreas have to work extra hard to produce more insulin to overcome insulin resistance. This overwork leads to beta-cell exhaustion, later the beta cells’ death, resulting in decreased insulin production and high blood sugar.
Insulin resistance associated with
- high blood pressure
- high triglycerides
- low good (HDL) Cholesterol
- obesity
- impaired glucose tolerance
- impaired fasting glucose
- gestational diabetes
- polycystic ovarian syndrome
- Type 2 Diabetes.
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