In normal physiology, glucagon from pancreatic alpha cells plays an important role in maintaining glucose homeostasis via its regulatory effect on hepatic glucose production. Patients with type 2 diabetes exhibit elevated plasma glucagon levels in the fasting state, and glucagon concentrations fail to decrease appropriately and may even increase in response to ingestion of glucose and after ingestion of a mixed meal.
Background: Obesity and type 2 diabetes represent a world-wide problem and their treatment is a growing concern. Roux-en-Y gastric bypass surgery (RYGB) is currently the most successful treatment with diabetes remission rates of 50-80 % and weight loss of 30% in obese individuals. Most importantly, mortality is reduced about 30 %. These results show that there are mechanisms within our own body that can cure diabetes and obesity.
As emergence of precision medicine brings along the great promise of health-care decisions tailored to the individual, the discovery of early risk factors becomes paramount. The growth of longitudinal biomedical data including nation-wide registers, genetics, health records and metabolomics creates a unique opportunity to develop novel methods for predicting of onset, trajectories and outcomes of complex diseases early and in a non-invasive manner.
Type 2 diabetes (T2D) complications currently put a tremendous burden on health care systems. In order to improve survival and care of patients with T2D and hinder chronic complications, we must improve our understanding of the pathways and predictors of these complications. Mannan-binding lectin (MBL) is a multifunctional protein involved in innate immunity that may have a dual role in affecting both susceptibility of infections and micro- and macrovascular complications in T2D.
The prevalence of Type 2 diabetes mellitus (T2DM) is increasing in Denmark as well as worldwide. The obesity epidemic is one of the main drivers behind this development. Since conventional obesity treatments are seldom long-term successful, focus has turned to surgical treatments of obesity and T2DM. One of the most common bariatric procedures, Roux-en-Y gastric bypass surgery (RYGB), does not only result in large, sustained weight loss, but also appears to substantially improve obesity-related co-morbidities including T2DM.
Exercise elicits phenotypic alterations in skeletal muscle which impact positively on muscle function and metabolic health. Many of these adaptations are orchestrated by AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (mTORC)1, but the subcellular locations of the signaling and its exact molecular links to Diabetes-relevant downstream processes such as autophagy and mitochondrial function remain unclear.
It is known that the three microvascular complications of diabetes, affecting the retina, kidney and peripheral nervous system, are determined to a large degree by how well glucose levels are managed and by the duration of diabetes. However, even at a similar level of glycaemic control and diabetes duration, some patients develop complications earlier and experience a more aggressive progression of these complications than others.
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