Diabetologia ( IF 8.4 ) Pub Date : 2021-07-22 , DOI: 10.1007/s00125-021-05505-4 James D Johnson 1, 2
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Hundreds of millions of people are affected by hyperinsulinaemia, insulin resistance, obesity and the dysglycaemia that mark a common progression from metabolic health to type 2 diabetes. Although the relative contribution of these features and the order in which they appear may differ between individuals, the common clustering and seemingly progressive nature of type 2 diabetes aetiology has guided research and clinical practice in this area for decades. At the same time, lively debate around the causal relationships between these features has continued, as new data from human trials and highly controlled animal studies are presented. This ‘For debate’ article was prompted by the review in Diabetologia by Esser, Utzschneider and Kahn (https://doi.org/10.1007/s00125-020-05245-x), with the purpose of reviewing established and emerging data that provide insight into the relative contributions of hyperinsulinaemia and impaired glucose-stimulated insulin secretion in progressive stages between health, obesity and diabetes. It is concluded that these beta cell defects are not mutually exclusive and that they are both important, but at different stages.
Graphical abstract
中文翻译：
2型糖尿病患者高胰岛素血症、胰岛素抵抗、肥胖和血糖异常的因果关系
数以亿计的人受到高胰岛素血症、胰岛素抵抗、肥胖和血糖异常的影响，这标志着从代谢健康到 2 型糖尿病的常见进展。尽管这些特征的相对贡献和它们出现的顺序可能因人而异，但 2 型糖尿病病因的共同聚集和看似渐进的性质已经指导了该领域的研究和临床实践数十年。与此同时，随着来自人体试验和高度受控动物研究的新数据的出现，围绕这些特征之间因果关系的激烈辩论仍在继续。这篇“辩论”文章是由Diabetologia中的评论引起的作者：Esser、Utzschneider 和 Kahn (https://doi.org/10.1007/s00125-020-05245-x)，目的是审查既定数据和新数据，这些数据可以深入了解高胰岛素血症和葡萄糖刺激胰岛素受损的相对贡献在健康、肥胖和糖尿病之间的渐进阶段分泌。得出的结论是，这些β细胞缺陷不是相互排斥的，它们都很重要，但处于不同的阶段。
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