Manish Agarwal & Shilpa Agarwal
Doctor, Medilink Hospital, India
Biography:
Abstract:
Type 2 diabetes is a metabolic disorder characterized by insulin resistance and decreased insulin secretion. Several mechanisms have been described to explain impaired insulin secretion and function in type 2 diabetes and these mechanisms are glucotoxicity, lipotoxicity, oxidative stress, endoplasmic reticulum stress & amyloi deposition. These are linked with each other & they cause inflammation in tissues. Inflammation in islet cells cause destruction or failure of β cells. This leads to defect of insulin secretion. Inflammation also occurs in insulin sensitive tissues e.g., liver,muscle & adipose tissue. When a person gains weight, his adipocytes become phenotypically different. Macrophages infiltrate & inflammatory mediators are secreted – leading to inflammation & ultimately development of insulin resistance. IL - 1β & NLRP 3 inflammasome are important mediators of these inflammation. Similar things happen in muscle or liver also. These findings are mainly from preclinical studies. Even studies in humans also revealed association between inflammatory markers & type 2 diabetes. So all of this show that type 2 diabetes develops due to tissue inflammation precipitated by obesity. So some anti-inflammatory agents are currently undergoing trials to evaluate their effect on type 2 diabetes or prediabetes. IL- 1 blockers, IL - 1β specific antibodies, salsalate are some of those agents. Few studies have shown to improve insulin sensitivity & reduction of glycemic parameters. Others are expected to be completed in near future. So they can be a new group of drugs which can prevent or control type 2 diabetes.