Type 2 diabetes mellitus in adults:pathogenesis,prevention and therapy  

作　　者：Xi Lu Qingxing Xie Xiaohui Pan Ruining Zhang Xinyi Zhang Ge Peng Yuwei Zhang Sumin Shen Nanwei Tong 

机构地区：[1]1Department of Endocrinology and Metabolism,Research Centre for Diabetes and Metabolism,West China Hospital,Sichuan University,Chengdu,China

出　　处：《Signal Transduction and Targeted Therapy》2024年第11期4791-4815,共25页信号转导与靶向治疗（英文）

基　　金：supported by the National Nature Science Foundation of China(82170830);grants from the 1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(No.ZYGD 18017);grants from Nature Science Foundation of Department of Science and Technology of Sichuan Province(China)(2023YFS0078).

摘　　要：Type 2 diabetes(T2D)is a disease characterized by heterogeneously progressive loss of isletβcell insulin secretion usually occurring after the presence of insulin resistance(IR)and it is one component of metabolic syndrome(MS),and we named it metabolic dysfunction syndrome(MDS).The pathogenesis of T2D is not fully understood,with IR andβcell dysfunction playing central roles in its pathophysiology.Dyslipidemia,hyperglycemia,along with other metabolic disorders,results in IR and/or isletβcell dysfunction via some shared pathways,such as inflammation,endoplasmic reticulum stress(ERS),oxidative stress,and ectopic lipid deposition.There is currently no cure for T2D,but it can be prevented or in remission by lifestyle intervention and/or some medication.If prevention fails,holistic and personalized management should be taken as soon as possible through timely detection and diagnosis,considering target organ protection,comorbidities,treatment goals,and other factors in reality.T2D is often accompanied by other components of MDS,such as preobesity/obesity,metabolic dysfunction associated steatotic liver disease,dyslipidemia,which usually occurs before it,and they are considered as the upstream diseases of T2D.It is more appropriate to call“diabetic complications”as“MDS-related target organ damage(TOD)”,since their development involves not only hyperglycemia but also other metabolic disorders of MDS,promoting an up-to-date management philosophy.In this review,we aim to summarize the underlying mechanism,screening,diagnosis,prevention,and treatment of T2D,especially regarding the personalized selection of hypoglycemic agents and holistic management based on the concept of“MDS-related TOD”.

关 键 词：PREVENTION PATHOGENESIS DIAGNOSIS 

分 类 号：R587.1[医药卫生—内分泌]