Banting Memorial lecture 2012: reversing the twin cycles of type 2 diabetes

Diabetic Medicine : a Journal of the British Diabetic Association
R Taylor

Abstract

It has become widely accepted that Type 2 diabetes is inevitably life-long, with irreversible and progressive beta cell damage. However, the restoration of normal glucose metabolism within days after bariatric surgery in the majority of people with Type 2 diabetes disproves this concept. There is now no doubt that this reversal of diabetes depends upon the sudden and profound decrease in food intake, and does not relate to any direct surgical effect. The Counterpoint study demonstrated that normal glucose levels and normal beta cell function could be restored by a very low calorie diet alone. Novel magnetic resonance methods were applied to measure intra-organ fat. The results showed two different time courses: a) resolution of hepatic insulin sensitivity within days along with a rapid fall in liver fat and normalisation of fasting glucose levels; and b) return of normal beta cell insulin secretion over weeks in step with a fall in pancreas fat. Now that it has been possible to observe the pathophysiological events during reversal of Type 2 diabetes, the reverse time course of events which determine the onset of the condition can be identified. The twin cycle hypothesis postulates that chronic calorie excess leads to accumulati...Continue Reading

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Citations

Apr 9, 2013·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Mary Pierce
Apr 18, 2014·Current Diabetes Reports·Rohit B Sharma, Laura C Alonso
Feb 20, 2016·Endocrinology and Metabolism Clinics of North America·Kevin C MakiSeth J Baum
May 6, 2014·Journal of Clinical Lipidology·Kevin C Maki The Diabetes Subpanel of the National Lipid Association Expert Panel
Nov 21, 2014·Journal of Diabetes Investigation·Søs Skovsø
May 6, 2015·Cardiology Clinics·Kevin C MakiSeth J Baum
May 26, 2016·Diabetes Care·Rachel L Batterham, David E Cummings
Feb 14, 2017·Journal of Translational Internal Medicine·Gerald H Tomkin, Daphne Owens
Jan 17, 2020·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Weili YangJichun Yang
Aug 3, 2016·American Journal of Lifestyle Medicine·George E Guthrie
May 16, 2017·American Journal of Lifestyle Medicine·George E Guthrie
Jan 29, 2017·American Journal of Lifestyle Medicine·George E Guthrie
Apr 12, 2020·International Journal of Environmental Research and Public Health·Tara KellyFrancis Finucane
Mar 13, 2020·Diabetes/metabolism Research and Reviews·Srikanth TangellojuScott LaJoie
Jun 13, 2020·Nature Medicine·Sarah E BerryTim D Spector
May 8, 2015·Annals of Clinical Biochemistry·Anita SarkerAdrian Park
Jul 17, 2019·The Proceedings of the Nutrition Society·Louise M GoffOluwatoyosi Bello
Mar 4, 2021·Metabolic Syndrome and Related Disorders·Arthur Swislocki
Jul 30, 2021·Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association·Adrian BrownDuane Mellor
Sep 2, 2021·Current Opinion in Endocrinology, Diabetes, and Obesity·Peter J Foley
Dec 14, 2021·Frontiers in Digital Health·Kimberly R AzeltonMatthew J Landry

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Methods Mentioned

BETA
gastric bypass
biopsy

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