Lookup NU author(s): Professor Roy Taylor
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© 2016 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Type 2 diabetes causes major global health problems and has been believed to be a lifelong condition with inevitable worsening. Steadily increasing numbers of drugs appeared to be required to achieve even modest control. Early type 2 diabetes has now been shown to be reversed by substantial weight loss and this has allowed temporal tracking of the underlying pathophysiological changes. Areas covered: In early type 2 diabetes, negative calorie balance decreases liver fat within days, and allows return of normal control of hepatic glucose production. Over 8 weeks, the negative calorie balance allows the raised levels of intra-pancreatic fat and simultaneously first phase insulin secretion to normalise. These findings are consistent with the 2008 Twin Cycle Hypothesis of the etiology and pathogenesis of type 2 diabetes. Individuals develop type 2 diabetes when they exceed their personal fat threshold for safe storage of fat and there is no difference in pathophysiology between those with BMI above or below 30 kg/m2. Expert commentary: Type 2 diabetes can now be understood as a state of excess fat in liver and pancreas, and remains reversible for at least 10 years in most individuals.
Author(s): Taylor R
Publication type: Review
Publication status: Published
Journal: Expert Review of Endocrinology and Metabolism
Online publication date: 30/09/2016
Acceptance date: 19/09/2016
ISSN (print): 1744-6651
ISSN (electronic): 1744-8417
Publisher: Taylor and Francis Ltd