Mecanismos fisiopatológicos de la diabetes mellitus 2 / Physiopathological mechanisms of type 2 diabetes mellitus

ABSTRACT

Classically, it has been attributed to muscle and liver insulin resistance (IR) the main responsibility in the pathogenesis of type 2 diabetes mellitus (DM2). To date, several authors have shown the involvement of other components in its progression. The adipose tissue plays an importantrole for the increase in circulating free fatty acids due to enhanced lipolysis, which results in increased liver and muscle IR. Incretins, secreted in small bowel, potentiate insulin secretionin response to the ingestion of fat and carbohydrate. In type 2 diabetic subjects, it has been demonstrated alterations in its levels. In the diabetic kidney, increases in SGLT2 transporterexpression, enhances glucose reabsorption. Also in the brain, IR could be manifested, determining changes in appetite and satiety regulation. Finally, increased levels of glucagon and the progression of beta cell failure, determine the onset of hyperglycemia. The mechanism through each of them determines IR and progression to DM2 are reviewed.