Professor, Endocrinology, Diabetes, Metabolism, and Nutrition ,Mayo Clinic
Location: United States
Adrian Vella, M.D., studies the pathogenesis of type 2 diabetes.
Type 2 diabetes is a common metabolic disorder that arises out of a complex interaction between genes and the environment. The disease is characterized by insulin secretion that is inappropriate to the prevailing glucose concentrations, in part because of defects in insulin synthesis and in part because of defects in the ability of glucose and insulin to stimulate glucose uptake and suppress glucose production. Type 2 diabetes is preceded by an intermediate condition called prediabetes, which occurs during the transition from normal fasting glucose to diabetes. During this time, affected individuals have elevated fasting or postprandial glucose concentrations but do not fulfill the criteria for the diagnosis of diabetes.
Individuals with prediabetes are at high risk of progression to diabetes. For example, people with a fasting glucose greater than 110 milligrams per deciliter (mg/dL), or 6.1 millimoles per liter (mmol/L) — 10 mg/dL (0.6 mmol/L) above normal fasting — have a 40 percent greater risk of developing diabetes. While this is high, the converse argument is that 60 percent of such patients never develop diabetes. Dr. Vella is investigating this heterogeneity; greater understanding will provide clues to the pathogenesis of diabetes.
Focus areas
Significance to patient care
A better understanding of the processes that interact to cause the defects present in type 2 diabetes has important implications in terms of preventing and treating the disease. Understanding how genes and the environment interact to affect insulin secretion, insulin action, weight and appetite will help inform more rational treatments for type 2 diabetes.
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