A Unified Pathophysiological Construct of Diabetes and its Complications

Trends Endocrinol Metab. 2017 Sep;28(9):645-655. doi: 10.1016/j.tem.2017.05.005. Epub 2017 Jun 16.

Abstract

Advances in understanding diabetes mellitus (DM) through basic and clinical research have helped clarify and reunify a disease state fragmented into numerous etiologies and subtypes. It is now understood that a common pathophysiology drives the diabetic state throughout its natural history and across its varied clinical presentations, a pathophysiology involving metabolic insults, oxidative damage, and vicious cycles that aggravate and intensify organ dysfunction and damage. This new understanding of the disease requires that we revisit existing diagnostics and treatment approaches, which were built upon outmoded assumptions. 'The Common Pathophysiologic Origins of Diabetes Mellitus and its Complications Construct' is presented as a more accurate, foundational, and translatable construct of DM that helps make sense of the hitherto ambiguous findings of long-term outcome studies.

Keywords: Common Origins of Diabetes and its Complications Construct; Egregious Eleven; complications; pathophysiology; type 2 diabetes; β Cell-Centric Model.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Diabetes Complications / etiology*
  • Diabetes Complications / metabolism
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / metabolism
  • Humans
  • Metabolic Networks and Pathways / physiology
  • Models, Biological
  • Oxidative Stress / physiology