From Stockholm, Sweden:
I have heard rumors that a US university recently has proven that it is hyperinsulinemia that precedes obesity long before the onset of type 2 diabetes. Do you know, and if so, could you please indicate the university/department/experts who are responsible for this important finding?
I think that it would be a mistake to suppose that the relationships between type 2 diabetes, obesity and hyperinsulinism have a single underlying pathology. There is one study that supports what you said, but it really only applies to middle aged women. (See Mogul HR, Weinstein BI, Mogul DB, Peterson SJ, Zhang S, Frey M, Gambert SR, Southren AL. See Syndrome W: a new model of hyperinsulinemia, hypertension and midlife weight gain in healthy women with normal glucose tolerance. (Heart Dis 2002 Mar-Apr;4(2):78-85.) There are other studies that point convincingly to the point of view that obesity as a reflection of lifestyle is the more important predictor of type 2 diabetes. Furthermore, there are no reports yet on the impact of disorders of the new appetite controlling hormones like PYY and Ghrelin although the role of Leptin is beginning to be understood.
Additional comments from Dr. Stuart Brink:Many professors and universities have claimed this: insulin resistance seems to be the hallmark of obesity and may actually drive obesity. You may be talking about work of Professor Gerry Reaven at Stanford but Defronzo in Texas, Lebovitz in New York, Horton in Boston as well as Arslanian in Pittsburgh, all of whom have done extensive research. Many others have also done such research. If you went to PubMed or some other medical literature search engine and looked for insulin resistance and obesity, you would likely find thousands of such articles from the USA and many other countries around the world.
Original posting 14 Nov 2002
Posted to Type 2
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