The global diabetes epidemic as a consequence of lifestyle-induced low-grade inflammation

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

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.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / etiology
  • Diabetes Mellitus / immunology
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / genetics
  • Dietary Carbohydrates / adverse effects
  • Dietary Fats / adverse effects
  • Disease Outbreaks
  • Global Health
  • Glucose / metabolism
  • Humans
  • Inflammation / complications
  • Inflammation / epidemiology*
  • Inflammation / immunology
  • Life Style*
  • Muscle, Skeletal / physiology
  • Muscle, Skeletal / physiopathology
  • Obesity / complications
  • Obesity / epidemiology
  • Prevalence
  • Starch / metabolism
  • World Health Organization

Substances

  • Dietary Carbohydrates
  • Dietary Fats
  • Starch
  • Glucose