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Pathogenesis of Type 2 Diabetes

Islet b-cell

Impaired
Insulin Secretion

Increased Decreased Glucose


HGP Uptake

HGP=hepatic glucose production.


Pathogenesis of Type 2 Diabetes
Islet b-cell

Impaired
Insulin Secretion

Increased Decreased Glucose


HGP Uptake
Pathogenesis of Type 2 Diabetes
Islet b-cell

Impaired
Insulin Secretion

Increased Decreased Glucose


HGP Uptake
The Disharmonious Quartet

Islet b-cell

↑ FFA Increased
Lipolysis
Impaired
Insulin Secretion

Increased
HGP
Decreased Glucose
Uptake
FFA=free fatty acids.
The Quintessential Quintet

Islet b-cell

Decreased
Incretin Effect

Impaired
Insulin Secretion
Increased
Lipolysis

Increased
HGP Decreased Glucose
Uptake
The Setaceous Sextet
Islet b-cell

Decreased
Incretin Effect
Impaired
Insulin Secretion

Islet a-cell

Increased
Lipolysis

Increased
Glucagon Secretion

Increased
HGP Decreased Glucose
Uptake
The Septicidal Septet

Islet b-cell

Decreased
Impaired Incretin Effect
Insulin Secretion Increased
Lipolysis

Islet a-cell

Increased
Increased Glucose
Glucagon Secretion
Reabsorption

Increased
HGP Decreased Glucose
Uptake
The Ominous Octet

Islet b-cell

Decreased
Incretin Effect
Increased
Impaired Lipolysis
Insulin Secretion

Islet a-cell

Increased Increased Glucose


Glucagon Secretion Reabsorption

Increased
Decreased Glucose
HGP
Neurotransmitter Uptake
Dysfunction
Treatment of Type 2 Diabetes: A Sound
Approach Based Upon Its Pathophysiology

Islet b-cell
TZDs
GLP-1 analogues

Impaired
 DPP-4 Inhibitors
Sulfonylureas/
Increased
Lipolysis
Insulin Secretion
Meglitinides
TZDs

Metformin


TZDs TZDs
Metformin

Increased
HGP
Decreased Glucose
Uptake
DPP-4=dipeptidyl peptidase-4.

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