Dr. Jim Johnson, Deputy Director of the Life Sciences Institute, has published a reflection on the lively debate around the high insulin levels, insulin resistance, obesity and unstable blood sugar levels that mark common progression from metabolic health to type 2 diabetes.
Although the sequence in which these features appear may differ among individuals, the seemingly progressive nature of type 2 diabetes and its origins have guided research and clinical practice for decades. At the same time, new data from human trials and highly controlled animal studies and intense discussion about the causal relationships continues.
Prompted by a review in Diabetologia by Esser, Utzschneider and Kahn (https://doi.org/10.1007/s00125-020-05245-x), Johnson penned his reflection “with the purpose of reviewing established and emerging data that provide insight into the relative contributions of hyperinsulinaemia and impaired glucose-stimulated insulin secretion in progressive stages between health, obesity and diabetes. It is concluded that these beta cell defects are not mutually exclusive and that they are both important, but at different stages.”
Johnson, J.D. On the causal relationships between hyperinsulinaemia, insulin resistance, obesity and dysglycaemia in type 2 diabetes. Diabetologia (2021). https://doi.org/10.1007/s00125-021-05505-4