This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (1)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • Nutritional and Metabolic Disorders  • Nutritional and Metabolic Disorders, Other  • Exercise  • Obesity  • Diet  • Endocrine Diseases  • Diabetes Mellitus  • Alert me on articles by topic  Social Bookmarking   What's this?

Pathogenesis, Treatment, and Prevention

Roger H. Unger, MD

JAMA. 2008;299(10):1185-1187.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The conventional glucocentric perspective of type 2 diabetes views hyperglycemia as a primary disease caused by an etiologically uncertain combination of obesity-associated insulin resistance and beta cell loss (a disease of glucose metabolism to be treated with antihyperglycemic agents, including high-dose insulin, if necessary). By contrast, the novel lipocentric view depicts the hyperglycemia of type 2 diabetes, and the underlying insulin resistance and beta cell loss, as being secondary to the metabolic trauma caused by ectopic lipid deposition or lipotoxicity.¹ If this is in fact the case, hyperglycemia should be corrected by eliminating the lipid overload. The study by Dixon et al² provides support for this lipocentric hypothesis, by demonstrating that weight loss that follows gastric banding is accompanied by remission of diabetes in 73% of obese patients with type 2 diabetes. This finding supports 45 years of biochemical, physiological, and clinical research pointing to lipid . . . [Full Text of this Article]

History of the Lipocentric Concept

Author Affiliations: Touchstone Center for Diabetes Research, University of Texas Southwestern Medical Center, and Veterans Affairs Medical Center, Dallas, Texas.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Insulin Therapy and Lipid Overload in Type 2 Diabetes
Paresh Dandona, Ajay Chaudhuri, and Husam Ghanim
JAMA. 2008;300(7):788-789.
EXTRACT | FULL TEXT  

Insulin Therapy and Lipid Overload in Type 2 Diabetes
Raffaele Marfella, Michelangela Barbieri, and Giuseppe Paolisso
JAMA. 2008;300(7):789.
EXTRACT | FULL TEXT  

Insulin Therapy and Lipid Overload in Type 2 Diabetes—Reply
Roger H. Unger
JAMA. 2008;300(7):790.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Myocardial lipid accumulation in patients with pressure-overloaded heart and metabolic syndrome
Marfella et al.
J. Lipid Res. 2009;50:2314-2323.
ABSTRACT | FULL TEXT  

Noninvasive Quantification of Pancreatic Fat in Humans
Lingvay et al.
J. Clin. Endocrinol. Metab. 2009;94:4070-4076.
ABSTRACT | FULL TEXT  

Two Risk-Scoring Systems for Predicting Incident Diabetes Mellitus in U.S. Adults Age 45 to 64 Years
Kahn et al.
ANN INTERN MED 2009;150:741-751.
ABSTRACT | FULL TEXT  

Insulin Therapy and Lipid Overload in Type 2 Diabetes
Marfella et al.
JAMA 2008;300:789-789.
FULL TEXT  

Insulin Therapy and Lipid Overload in Type 2 Diabetes
Dandona et al.
JAMA 2008;300:788-789.
FULL TEXT