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Appropriate therapy for type 2 diabetes mellitus in view of pancreatic β-cell glucose toxicity: "the earlier, the better".
- Source :
-
Journal of diabetes [J Diabetes] 2016 Mar; Vol. 8 (2), pp. 183-9. Date of Electronic Publication: 2015 Oct 27. - Publication Year :
- 2016
-
Abstract
- Pancreatic β-cells secrete insulin when blood glucose levels become high; however, when β-cells are chronically exposed to hyperglycemia, β-cell function gradually deteriorates, which is known as β-cell glucose toxicity. In the diabetic state, nuclear expression of the pancreatic transcription factors pancreatic and duodenal homeobox 1 (PDX-1) and v-Maf musculoaponeurotic fibrosarcoma oncogene family, protein A (MafA) is decreased. In addition, incretin receptor expression in β-cells is decreased, which is likely involved in the impairment of incretin effects in diabetes. Clinically, it is important to select appropriate therapy for type 2 diabetes mellitus (T2DM) so that β-cell function can be preserved. In addition, when appropriate pharmacological interventions against β-cell glucose toxicity are started at the early stages of diabetes, β-cell function is substantially restored, which is not observed if treatment is started at advanced stages. These observations indicate that it is likely that downregulation of pancreatic transcription factors and/or incretin receptors is involved in β-cell dysfunction observed in T2DM and it is very important to start appropriate pharmacological intervention against β-cell glucose toxicity in the early stages of diabetes.<br /> (© 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.)
- Subjects :
- Blood Glucose metabolism
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 pathology
Humans
Hyperglycemia blood
Insulin Secretion
Insulin-Secreting Cells metabolism
Severity of Illness Index
Time Factors
Transcription Factors metabolism
Diabetes Mellitus, Type 2 drug therapy
Hyperglycemia drug therapy
Hypoglycemic Agents therapeutic use
Insulin metabolism
Insulin-Secreting Cells drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1753-0407
- Volume :
- 8
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of diabetes
- Publication Type :
- Academic Journal
- Accession number :
- 26223490
- Full Text :
- https://doi.org/10.1111/1753-0407.12331