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Review
. 2010 Jan;53(1):10-20.
doi: 10.1007/s00125-009-1573-7. Epub 2009 Nov 5.

The Global Diabetes Epidemic as a Consequence of Lifestyle-Induced Low-Grade Inflammation

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Review

The Global Diabetes Epidemic as a Consequence of Lifestyle-Induced Low-Grade Inflammation

H Kolb et al. Diabetologia. .

Abstract

The recent major increase in the global incidence of type 2 diabetes suggests that most cases of this disease are caused by changes in environment and lifestyle. All major risk factors for type 2 diabetes (overnutrition, low dietary fibre, sedentary lifestyle, sleep deprivation and depression) have been found to induce local or systemic low-grade inflammation that is usually transient or milder in individuals not at risk for type 2 diabetes. By contrast, inflammatory responses to lifestyle factors are more pronounced and prolonged in individuals at risk of type 2 diabetes and appear to occur also in the pancreatic islets. Chronic low-grade inflammation will eventually lead to overt diabetes if counter-regulatory circuits to inflammation and metabolic stress are compromised because of a genetic and/or epigenetic predisposition. Hence, it is not the lifestyle change per se but a deficient counter-regulatory response in predisposed individuals which is crucial to disease pathogenesis. Novel approaches of intervention may target these deficient defence mechanisms.

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