Skill Checkup: A 36-Year-Old Man With Type 2 Diabetes Is Struggling to Lose Weight

Anne L. Peters, MD

Disclosures

June 01, 2022

Type 2 diabetes is characterized by a combination of low amounts of insulin production from pancreatic beta-cells and peripheral insulin resistance. Insulin resistance leads to elevated fatty acids in the plasma, causing decreased glucose transport into the muscle cells, as well as increased fat breakdown, subsequently leading to elevated hepatic glucose production. Insulin resistance and pancreatic beta-cell dysfunction must occur simultaneously for type 2 diabetes to develop. Anyone who has overweight or has obesity has some level of insulin resistance, but diabetes develops only in those individuals who lack sufficient insulin secretion to match the degree of insulin resistance. Insulin in those people may be high, yet it is not enough to normalize the level of glycemia.

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