|
 |
|
|||||||
|
|||||||||
DOI: 10.2337/db07-9903
© 2007 by the American Diabetes Association
Banting Lecture 2006 |
Orchestration of Glucose Homeostasis
From a Small Acorn to the California Oak
From the Keck School of Medicine, University of Southern California, Los Angeles, California
Address correspondence and reprint requests to Richard N. Bergman, PhD, Keck Professor of Medicine, and Chair, Department of Physiology and Biophysics, Keck School of Medicine, MMR626, 1333 San Pablo St., Los Angeles, CA 90033. E-mail: rbergman@usc.edu
Abbreviations:
CNS, central nervous system; FFA, free fatty acid; GIP, glucose-dependent insulinotropic peptide; GLP-1, glucagon-like pepetide-1
| The first 300 words of the full text of this article appear below. |
Type 2 diabetes is increasing at alarming rates in the U.S., in Westernized countries, and in the third world. The increasing costs in terms of human suffering as well as economics are well recognized (1). Improved understanding of the pathogenesis of diabetes should lead to better approaches to predict, forestall, or even prevent diabetes and to treat extant cases. Yet, the precise causes of this disease remain to be totally explained. There is little question that obesity per se is a primary contributor, but the causes of the so-called "obesity epidemic" are in debate (2), as are the mechanisms by which obesity itself is linked to diabetes (3,4).
For some years, our laboratory has been engaged in efforts to understand causation of type 2 diabetes in terms of insulin secretion and resistance and to attempt to account for the role of obesity. The Banting Lecture provided me with a rare opportunity to describe our research efforts done over a prolonged history in a single presentation. It was my goal to address the several areas of diabetes research we have done. At first glance these different areas may appear unrelated. But these lines of work are closely linked within an overall effort to understand diabetes. I am deeply grateful to the members of the American Diabetes Association for the great privilege of making this presentation. I hope I will be able to emphasize the wonderful opportunity that I and my colleagues have had to pursue original research in a highly deserving and important cause. One can scarcely ask for more in one's professional life.
For several decades it has been popular to pursue a "reductionist" approach to studying disease (Fig. 1). The underlying concept is that understanding of disease will result
 |
SYSTEMS ANALYSIS AND DIABETES |
|---|
The minimal model.
Emergent research.
|
BRANCH #1: Clinical tools and the disposition index |
|---|
Physiologic parameters from the minimal model.
Applications of the minimal model.
Disposition index.
Interpretation of DI.
Genetics of DI.
What is the mechanistic explanation for the "Hyperbolic Law of Glucose Tolerance"?
|
BRANCH #2: Transendothelial transport and insulin resistance |
|---|
Implications of sluggish transendothelial transport of insulin.
|
BRANCH #3: The role of FFAs in insulin action and glucose homeostasis |
|---|
Search for the signal mediating insulin action.
The role of FFA in pathogenesis of the metabolic syndrome.
Hyperinsulinemic compensation for insulin resistance: putative role of nocturnal FFAs.
Hypothesis integrating the role of FFAs in the metabolic syndrome.
|
THE TREE, ITS RICH SOIL, AND ITS FERTILIZERS |
|---|
|
Beloved colleagues |
|---|
CiteULike 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |