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Insulin Sensitivity or Resistance in Type 2 Diabetes Mellitus with Obesity

Saiedullah M

Type 2 diabetes mellitus, a state of hyperglycemia associated with beta cell dysfunction or insulin action on target cells. This state is often mediated or sustained by obesity linked inflammatrory cytokines. Tumor necrosis factor-alpha (TNF-α), most important inflammatory cytokine plays critical role in the pathogenesis of type 2 diabetes mellitus as evidenced from higher circulating levels of TNF-α in type 2 diabetes mellitus compared to controls and its negative influence on insulin secretion and insulin sensitivity in type 2 diabetes mellitus. Positive association of TNF-α with insulin secretion in subjects with impaired glucose regulation indicates its causal relationship betacell dysfunction, insulin resistance or sensitivity. In obese subjects with type 2 diabetes mellitus, we observed stronger and graded relationship between TNF-α and obesity.