Saisho Yoshifumi
Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
J Clin Med. 2014 Aug 14;3(3):923-43. doi: 10.3390/jcm3030923.
Type 2 diabetes (T2DM) is characterized by insulin resistance and beta cell dysfunction. Recent evidence has emerged that beta cell dysfunction is a common pathogenetic feature of both type 1 and type 2 diabetes, and T2DM never develops without beta cell dysfunction. Therefore, treatment of T2DM should aim to restore beta cell function. Although the treatment of T2DM has greatly improved over the past few decades, remaining issues in the current treatment of T2DM include (1) hypoglycemia; (2) body weight gain; (3) peripheral hyperinsulinemia and (4) postprandial hyperglycemia, which are all associated with inappropriate insulin supplementation, again underpinning the important role of endogenous and physiological insulin secretion in the management of T2DM. This review summarizes the current knowledge on beta cell function in T2DM and discusses the treatment strategy for T2DM in relation to beta cell dysfunction.
2型糖尿病(T2DM)的特征是胰岛素抵抗和β细胞功能障碍。最近有证据表明,β细胞功能障碍是1型和2型糖尿病共同的发病机制特征,且没有β细胞功能障碍就不会发生T2DM。因此,T2DM的治疗应旨在恢复β细胞功能。尽管在过去几十年中T2DM的治疗有了很大改善,但目前T2DM治疗中仍存在的问题包括:(1)低血糖;(2)体重增加;(3)外周高胰岛素血症;以及(4)餐后高血糖,这些都与不适当的胰岛素补充有关,这再次强调了内源性和生理性胰岛素分泌在T2DM管理中的重要作用。本综述总结了目前关于T2DM中β细胞功能的知识,并讨论了与β细胞功能障碍相关的T2DM治疗策略。