Metabolic alterations in Type 2 diabetes

The plasma glucose concentration in Type 2 diabetes varies according to the severity of the condition, but if a patient neglects his or her treatment and then attends a diabetic clinic, it would not be uncommon to find a plasma glucose concentration of 20 mmol/l. The plasma glucose concentration is consistently raised throughout the day (Fig. 10.4), with an exaggerated response to meals. This highlights the important role of insulin in minimising the postprandial 'excursions' in plasma glucose concentration, which is impaired in Type 2 diabetes. In addition, plasma non-esterified fatty acid concentrations may be elevated throughout the day (Fig. 10.5). This elevation of plasma non-esterified fatty acid concentration may aggravate a number of features of the condition, reducing further the ability of insulin to stimulate glucose uptake by skeletal muscle and promoting hepatic VLDL-triacylglycerol secretion.

Fig. 10.4 Twenty-four-hour profiles of plasma glucose concentration in non-diabetic subjects and subjects with severe Type 2 diabetes. The non-diabetic subjects were also shown in Fig. 6.1. Redrawn from data in Reaven et al. (1988), Copyright © 1988 American Diabetes Association. From Diabetes, Vol. 37, 1988; 1020-1024. With permission of the American Diabetes Association.

Fig. 10.4 Twenty-four-hour profiles of plasma glucose concentration in non-diabetic subjects and subjects with severe Type 2 diabetes. The non-diabetic subjects were also shown in Fig. 6.1. Redrawn from data in Reaven et al. (1988), Copyright © 1988 American Diabetes Association. From Diabetes, Vol. 37, 1988; 1020-1024. With permission of the American Diabetes Association.

Fig. 10.5 Twenty-four-hour profiles of plasma non-esterified fatty acid (NEFA) concentration in non-diabetic subjects and subjects with severe Type 2 diabetes.

Plasma glucose concentrations in these subjects are shown in Fig. 10.4. Redrawn from data in Reaven et al. (1988), Copyright © 1988 American Diabetes Association. From Diabetes, Vol. 37, 1988; 1020-1024. With permission of the American Diabetes Association.

Fig. 10.5 Twenty-four-hour profiles of plasma non-esterified fatty acid (NEFA) concentration in non-diabetic subjects and subjects with severe Type 2 diabetes.

Plasma glucose concentrations in these subjects are shown in Fig. 10.4. Redrawn from data in Reaven et al. (1988), Copyright © 1988 American Diabetes Association. From Diabetes, Vol. 37, 1988; 1020-1024. With permission of the American Diabetes Association.

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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