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Inflammation in the insulin-resistant endotype of diabetes: consequences for prevention and treatment

Entzündung beim insulinresistenten Endotyp des Diabetes: Konsequenzen für Prävention und Therapie

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Die Diabetologie Aims and scope

Abstract

The link between inflammation and insulin resistance is well-documented, particularly in the context of obesity, where chronic subclinical inflammation contributes to the development of type 2 diabetes. Recent efforts to subclassify diabetes into distinct endotypes based on key pathophysiological variables have revealed elevated levels of proinflammatory biomarkers in certain endotypes, such as the endotype with severe insulin-resistant diabetes (SIRD). Chronic inflammation not only amplifies the burden of diabetes but also undermines the efficacy of glucose-lowering medication, calling for targeted interventions to complement existing treatment. Addressing subclinical inflammation through lifestyle interventions and pharmacotherapeutic agents represents a promising avenue for both prevention and treatment, offering potential benefits in mitigating diabetes complications within personalized medicine.

Zusammenfassung

Der Zusammenhang zwischen Entzündung und Insulinresistenz ist gut dokumentiert, insbesondere im Zusammenhang mit Adipositas, wo chronische, subklinische Entzündungen zur Entwicklung von Typ-2-Diabetes beitragen. Aktuelle Bemühungen zur Unterteilung von Diabetes in verschiedene Endotypen basierend auf wichtigen pathophysiologischen Variablen haben erhöhte Spiegel von proinflammatorischen Biomarkern in bestimmten Endotypen aufgedeckt, wie zum Beispiel im Endotyp mit schwerem insulinresistentem Diabetes (SIRD). Chronische Entzündungen verstärken nicht nur die Belastung durch Diabetes, sondern beeinträchtigen auch die Wirksamkeit von blutzuckersenkenden Medikamenten, was gezielte Interventionen zur Ergänzung bestehender Behandlungen erforderlich macht. Die Modulation von subklinischer Entzündung durch Lebensstilinterventionen und Pharmakotherapeutika stellt einen vielversprechenden Ansatz für Prävention und Therapie dar und bietet potenzielle Vorteile bei der Milderung von Diabeteskomplikationen innerhalb der personalisierten Medizin.

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Authors and Affiliations

  1. Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225, Düsseldorf, Germany

    Martin Schön & Christian Herder

  2. German Center for Diabetes Research (DZD), München-Neuherberg, Germany

    Martin Schön & Christian Herder

  3. Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany

    Martin Schön & Christian Herder

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  1. Martin Schön
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  2. Christian Herder
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Correspondence to Martin Schön.

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M. Schön and C. Herder declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Schön, M., Herder, C. Inflammation in the insulin-resistant endotype of diabetes: consequences for prevention and treatment. Diabetologie (2024). https://doi.org/10.1007/s11428-024-01196-8

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  • DOI: https://doi.org/10.1007/s11428-024-01196-8

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