Research
Hormonal
Visceral adiposity and ectopic fat storage (in liver, muscle, and pancreas) drive insulin resistance and beta-cell dysfunction through mechanisms involving elevated NEFA, lipotoxicity, and adipocytokine secretion.
Where you store fat matters more than total weight. Visceral fat (around organs) and fat stored in the liver or muscles (ectopic fat) directly interfere with insulin signaling. Weight loss, specifically reducing visceral and ectopic fat, can significantly improve insulin sensitivity and beta-cell function.
GoodSupportsHIGH confidence
Excess abdominal fat mass is associated with an increased release of NEFA that may trigger a reduction in insulin sensitivity... ectopic triglyceride storage... has been emphasized leading to the concept of lipotoxicity.
Why this rating
Strong observational and mechanistic evidence cited, though some molecular details remain 'elusive'.
Source
PATHOPHYSIOLOGY OF TYPE 2 DIABETES
A J Scheen · Acta Clinica Belgica · 2003
DOI 10.1179/acb.2003.58.6.001
narrative_reviewCited 257×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Type 2 diabetes pathogenesis requires the concurrent presence of both insulin resistance and beta-cell dysfunction, as neither defect alone is typically sufficient to cause overt glucose intolerance.Strong
- Adipose tissue acts as an endocrine organ secreting adipocytokines (e.g., TNF-alpha, resistin, adiponectin) that modulate insulin sensitivity and beta-cell function.Good
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