From Molecular Biology to Future Technologies in Management of Type 2 Diabetes

Presented by Steven R Smith, MD
Session I – Technologies for Metabolic Monitoring
Friday, October 29, 2004

Reviewed by Joelle Escoffery, PhD

The classic view of type 2 diabetes is as a disorder of glucose metabolism. However, disordered lipid metabolism may play an equally important role in the development of type 2 diabetes and was explored in this presentation.

According to the “glucocentric view,” as insulin resistance progresses, insulin secretion drops off due to β-cell failure. In this view, if apoptosis can be inhibited, β-cell failure can be prevented. Major clinical studies (TRIPOD, DPP) have demonstrated that certain pharmacologic agents may have value in preventing β-cell failure. An alternative view of type 2 diabetes is as a disorder of lipid metabolism. Insulin suppresses the release of fatty acids from fat cells. High levels of free fatty acids are associated with insulin resistance. Further, lipid defects may occur as early as glucose defects. Because disordered lipid metabolism plays an important role in type 2 diabetes, better technologies to measure lipids in vivo are needed, as lipid measurement technology lags way behind glucose measurement technology.