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The fourth Musketeer — from Alexandre Dumas to Claude Bernard

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Abstract

Considerations of the pathophysiology of non-insulin dependent diabetes mellitus (NIDDM) usually focus on the respective roles of the so-called triumviratebeta cell, muscle and liver [1]. Often overlooked in this context is the role of the adipose tissue, and attention is usually addressed to consideration of studies in which isolated adipocytes were used as a surrogate for muscle in studies of insulin action. The goal of this presentation will be to develop a radically different hypoteesis, and marshal evidence that it is the loss of normal regulation of adipose tissue that plays the central role in both the hyperglycaemia and the dyslipidaemia that characterizes patients with NIDDM.

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Abbreviations

IGT:

Impaired glucose tolerance

NEFA:

nonesterified fatty acids

HGP:

hepatic glucose production

FPG:

fasting plasma glucose

CHD:

coronary heart disease

TG:

triglyceride

VLDL-TG:

very low density lipoprotein-triglyceride

HTG:

hypertriglyceridaemia

IDDM:

insulin-dependent diabetes mellitus

NIDDM:

non-insulin-dependent diabetes mellitus

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Authors and Affiliations

  1. Department of Medicine, Stanford University School of Medicine and Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, 3801 Miranda Avenue, 94304, Palo Alto, California, USA

    G. M. Reaven

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Reaven, G.M. The fourth Musketeer — from Alexandre Dumas to Claude Bernard. Diabetologia 38, 3–13 (1995). https://doi.org/10.1007/BF02369347

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