Diabetes mellitus type 2: Pathophysiology and prevention [Diabetes mellitus Typ 2: Pathophysiologie und̈ Pravention]

The growing number of patients with diabetes cannot be explained solely by genetic predisposition; there are numerous exogenous risk factors that are to a large extent based on people's changing lifestyles. Numerous studies published in 2006 tried to answer the question of how lifestyle influences the onset and therapy of type 2 diabetes. Insulin resistance and insulin secretion are considered to be the most significant factors in its pathogenesis. The prevailing glycaemic status seems to be determined by the level of secreted insulin. Activated by subclinical inflammation, the immune system also plays a role in pathogenesis by secreting immune mediators. Finally, the level of adiponectin, a product of fat tissue, is an important factor in the onset of the disease. Overweight, lack of exercise, and suboptimal nutrition have been shown to be exogenous triggers of type 2 diabetes. Lifestyle interventions show the best results both in preventing diabetes and treating existing disease, and their long-term effects considerably improve quality of life and life expectancy, even beyond the time frame of the therapeutic intervention itself. © 2007 Springer Medizin Verlag.