Hormonal
In patients with type 2 diabetes, total adipocyte number is significantly lower than in BMI-matched obese subjects, indicating a failure of adipose tissue hyperplasia (cell number increase) to buffer excess fat.
For individuals with Type 2 Diabetes, the body's ability to expand fat storage capacity by creating new fat cells (hyperplasia) is impaired compared to non-diabetic obese individuals. This leads to larger existing fat cells (hypertrophy) and forces excess fat into visceral organs and muscles, worsening insulin resistance. Management should focus on preventing further fat accumulation to avoid ectopic fat deposition, as the structural capacity to store fat safely in subcutaneous tissue is limited.
Compared with BMI-matched obese subjects, patients with type 2 diabetes had 67% bigger very large adipocytes and 20% smaller small adipocyte size... Importantly, total adipocyte number was lower in patients with type 2 diabetes (P < 0.05)... This suggests that in individuals with type 2 diabetes, the number of adipocytes fails to increase as body fat increases.
Why this rating
Large sample size (n=260), rigorous matching for BMI, and use of validated measurement techniques (Coulter counter, CT), but it is an observational cross-sectional study, not an RCT.
Source
Lower Total Adipocyte Number but No Evidence for Small Adipocyte Depletion in Patients With Type 2 Diabetes
Magdalena Pasarica et al. · Diabetes Care · 2009
DOI 10.2337/dc08-2240
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