| Lilly lecture 2003: the struggle for mastery in insulin action: from triumvirate to republic. | |
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MedLine Citation:
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PMID: 15220184 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Type 2 diabetes arises from a combination of impaired insulin action and defective pancreatic beta-cell function. Classically, the two abnormalities have been viewed as distinct yet mutually detrimental processes. The combination of impaired insulin-dependent glucose metabolism in skeletal muscle and impaired beta-cell function causes an increase of hepatic glucose production, leading to a constellation of tissue abnormalities that has been referred to as the diabetes "ruling triumvirate." Targeted mutagenesis in mice has led to a critical reappraisal of the integrated physiology of insulin action. These studies indicate that insulin resistance in skeletal muscle and adipose tissue does not necessarily lead to hyperglycemia, so long as insulin sensitivity in other tissues is preserved. Additional data suggest a direct role of insulin signaling in beta-cell function and regulation of beta-cell mass, thus raising the possibility that insulin resistance may be the overarching feature of diabetes in all target tissues. I propose that we replace the original picture of a ruling triumvirate with that of a squabbling republic in which every tissue contributes to the onset of the disease. |
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Authors:
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Domenico Accili |
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Publication Detail:
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Type: Lectures; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Diabetes Volume: 53 ISSN: 0012-1797 ISO Abbreviation: Diabetes Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-06-28 Completed Date: 2004-09-16 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372763 Medline TA: Diabetes Country: United States |
Other Details:
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Languages: eng Pagination: 1633-42 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Naomi Berrie Diabetes Center, College of Physicians & Surgeons of Columbia University, Columbia University, New York, NY, USA. da230@columbia.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cell Division Diabetes Mellitus, Type 2 / etiology, genetics Forkhead Transcription Factors Genetic Predisposition to Disease Glucose / metabolism Humans Insulin / physiology* Insulin Resistance / genetics Islets of Langerhans / cytology, metabolism Liver / physiology Metaphor Muscle, Skeletal / metabolism Pancreatic Ducts / cytology Signal Transduction Transcription Factors / metabolism Transcription, Genetic |
| Chemical | |
Reg. No./Substance:
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0/Forkhead Transcription Factors; 0/Foxo1 protein, mouse; 0/Transcription Factors; 11061-68-0/Insulin; 50-99-7/Glucose |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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