Abstract
This short overview focuses on the causation and treatment of type 2 diabetes (T2D). Emphasis is given to the historical basis of understanding this disease and the background leading to emergence of the central role of insulin. The strengths of insulin administration in the treatment of diabetes are profound, but these need to be balanced against several serious shortcomings of its extended use. Some alternative approaches to T2D management are considered. Insulin is no longer considered as the first choice for type 2 diabetes, and an expanding range of new therapeutic possibilities is emerging. While these may lack the potency of insulin, at a minimum, they allow a major reduction in the intensity of insulin use. In view of the rising worldwide incidence of this disease, it is imperative to develop safe and inexpensive means of limiting its potential for impairment of normal functioning.
Highlights
Prediabetes means that blood glucose levels are higher than the normal range but not yet high enough to lead to a diagnosis of diabetes
The authors concluded that use of injected insulin predisposes to inflammation, atherosclerosis, hypertension, dyslipidemia, heart failure, and arrhythmias, showing that insulin therapy has an overall poorer safety profile than that found with several other therapies used to treat type 2 diabetes (T2D)
In mice subjected to a high-fat diet, inhibition of the heart-specific microRNA, miR-208a, with an antisense oligonucleotide leads to resistance to obesity induced by a high-fat diet and re-establishes systemic insulin sensitivity and glucose tolerance [68]
Summary
A brief history of the key steps in understanding and treating diabetes mellitus is given. Diabetes mellitus is a disease that has long been known and, over the centuries, knowledge concerning its nature has grown gradually and incrementally It was described in 1552 B.C. by Hesi-Ra, a famous physician/dentist of the Third Dynasty of Egypt. Matthew Dobson, an English physician, in 1776 described the sweetness of diabetic urine as being due to a sugar This idea was further developed a by a Scottish doctor, John Rollo, into the first recommendation of a low-carbohydrate diet for treating diabetes. The crucial role of the pancreas in diabetes was discovered in the 1880s by Joseph von Mehring (1849–1908), a German doctor, and Oscar Minkowski, a Russian pathologist, working together This led to the finding by Georg Zuelzer, a German scientist, that injection of pancreatic extracts could benefit diabetic patients. This protein can be manufactured synthetically and remains the primary treatment for diabetes
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