Normal weight individuals who develop type 2 diabetes: the personal fat threshold.

@article{Taylor2015NormalWI,
  title={Normal weight individuals who develop type 2 diabetes: the personal fat threshold.},
  author={Roy Taylor and Rury R. Holman},
  journal={Clinical science},
  year={2015},
  volume={128 7},
  pages={
          405-10
        }
}
Type 2 diabetes (T2DM) is frequently regarded as a disease of obesity and its occurrence in individuals of normal body mass index (BMI) is often regarded as indicating a non-obesity-related subtype. [] Key Method To illustrate this concept, we present the distribution curve of BMI at diagnosis for the UKPDS cohort, together with a diagram explaining individual behaviour within the population. The concept of PFT is of practical benefit in explaining the onset of diabetes and its logical management to the non…

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References

SHOWING 1-10 OF 58 REFERENCES

Non-obese patients with type 2 diabetes and prediabetic subjects: distinct phenotypes requiring special diabetes treatment and (or) prevention?

  • A. VaagS. Lund
  • Medicine, Biology
    Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme
  • 2007
Prevention of type 2 diabetes mellitus with lifestyle intervention is at least as effective in non-obese as in obese prediabetic subjects, and recent data suggest that metformin treatment targeting insulin resistance and non-glycemic cardiovascular disease risk factors is as beneficial in non/obese patients with T2DM.

DIET , LIFESTYLE , AND THE RISK OF TYPE 2 DIABETES MELLITUS IN WOMEN

The hypothesis that the majority of cases of type 2 diabetes could be prevented by the adoption of a healthier lifestyle is supported.

Diabetes incidence in Pima indians: contributions of obesity and parental diabetes.

In the Pimas, both obesity and diabetes have become more common during this century, perhaps as a result of rapid cultural and dietary changes in a population genetically susceptible to diabetes.

A Comparison of the Relative Effects of Obesity and Non-insulin-dependent Diabetes Mellitus on In Vivo Insulin-stimulated Glucose Utilization

The data emphasize the profound effect of NIDDM on reducing in vivo insulin action, and point out that the impact of obesity on insulin resistance is minor in comparison.

Long-term effect of metformin on blood glucose control in non-obese patients with type 2 diabetes mellitus

The present study demonstrated the long-term beneficial effect of metformin in non-obese (BMI < 25 kg/m2) diabetic patients and the observed worsening in glycemic control over time can probably be attenuated by increasing the dose of meetformin.

The impact of liver fat vs visceral fat in determining categories of prediabetes

Liver fat, more than visceral fat, strongly increases when glycaemia and glucose tolerance move from NGT to isolated IFG, isolated IGT and IFG+IGT, and it is worth searching for hepatokines more strongly predicting prediabetes categories.

Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol

Normalisation of both beta cell function and hepatic insulin sensitivity in type 2 diabetes was achieved by dietary energy restriction alone, and was associated with decreased pancreatic and liver triacylglycerol stores.

Effects of Weight Loss on Mechanisms of Hyperglycemia in Obese Non-Insulin-Dependent Diabetes Mellitus

In obese NIDDM, weight loss results in improved glucose homeostasis with improved postprandial glucose excursions with marked amelioration of peripheral insulin resistance due to improved postreceptor insulin action, which is at least partly due to enhanced glucose transport system activity.

Intrahepatic fat, not visceral fat, is linked with metabolic complications of obesity

Data demonstrate that IHTG, not VAT, is a better marker of the metabolic derangements associated with obesity, and alterations in tissue fatty acid transport could be involved in the pathogenesis of ectopic triglyceride accumulation by redirecting plasma fatty acid uptake from adipose tissue toward other tissues.
...