The DOI matches its Crossref record; 13 of the 13 references it cites were found in a registry or an index.
Normal weight individuals who develop Type 2 diabetes: the personal fat threshold
Open accessAbstract
Type 2 diabetes (T2DM) is frequently regarded as a disease of obesity and its occurrence in individuals of normal body mass index (BMI) is often regarded as indicating a non-obesity-related subtype. However, the evidence for such a distinct, common subtype is lacking. The United Kingdom Prospective Diabetes Study (UKPDS) cohort of people diagnosed with T2DM in the 1970s and 1980s had a median BMI of only 28 kg/m2. UKPDS data form the basis of current understanding of the condition even though one in three of those studied had a BMI of less than 25 kg/m2. BMI, though, is a population measure and not a rigid personal guide. Weight loss is considered de rigueur for treating obese diabetic individuals, but it is not usually considered for those deemed to have a normal BMI. Given the new evidence that early T2DM can be reversed to normal glucose tolerance by substantial weight loss, it is important to explain why non-overweight people respond to this intervention as well as obese individuals. We hypothesize that each individual has a personal fat threshold (PFT) which, if exceeded, makes likely the development of T2DM. Subsequent weight loss to take the individual below their level of susceptibility should allow return to normal glucose control. Crucially, the hypothesized PFT is independent of BMI. It allows both understanding of development of T2DM in the non-obese and remission of diabetes after substantial weight loss in people who remain obese by definition. To illustrate this concept, we present the distribution curve of BMI at diagnosis for the UKPDS cohort, together with a diagram explaining individual behaviour within the population. The concept of PFT is of practical benefit in explaining the onset of diabetes and its logical management to the non-obese majority of people with T2DM.
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Diet, lifestyle, and the risk of type 2 diabetes mellitus in women.
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Lim, E. L., Hollingsworth, K. G., Aribisala, B. S., Chen, M. J., Mathers, J. C., & Taylor, R. (2011) · Diabetologia · doi:10.1007/s00125-011-2204-7 · Cited by 1,164
Self-citationIntrahepatic fat, not visceral fat, is linked with metabolic complications of obesity
Fabbrini, E., Magkos, F., Mohammed, B. S., Pietka, T., Abumrad, N. A., Patterson, B. W., Okunade, A., & Klein, S. (2009) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0904944106 · Cited by 972
DIABETES INCIDENCE IN PIMA INDIANS: CONTRIBUTIONS OF OBESITY AND PARENTAL DIABETES1
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Taylor, R. (2013) · Diabetes Care · doi:10.2337/dc12-1805 · Cited by 485
Self-citationSchulz, L. O., Bennett, P. H., Ravussin, E., Kidd, J. R., Kidd, K. K., Esparza, J., & Valencia, M. E. (2006) · Diabetes Care · doi:10.2337/dc06-0138 · Cited by 420
Turner, R. C., Holman, R. R., Matthews, D., Hockaday, T. D. R., & Peto, J. (1979) · Metabolism · doi:10.1016/0026-0495(79)90146-x · Cited by 388
Self-citationHenry, R. R., Wallace, P., & Olefsky, J. M. (1986) · Diabetes · doi:10.2337/diab.35.9.990 · Cited by 325
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The Lancet Commission on diabetes: using data to transform diabetes care and patient lives
Chan, J. C. N., Lim, L.-L., Wareham, N. J., Shaw, J. E., Orchard, T. J., Zhang, P., Lau, E. S. H., Eliasson, B., Kong, A. P. S., Ezzati, M., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)32374-6 · Cited by 793
Self-citationObesity as a multisystem disease: Trends in obesity rates and obesity‐related complications
Sarma, S., Sockalingam, S., & Dash, S. (2021) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.14290 · Cited by 435
Steven, S., Hollingsworth, K. G., Al-Mrabeh, A., Avery, L., Aribisala, B., Caslake, M., & Taylor, R. (2016) · Diabetes Care · doi:10.2337/dc15-1942 · Cited by 418
Contribution of Adipose Tissue Inflammation to the Development of Type 2 Diabetes Mellitus
Burhans, M. S., Hagman, D. K., Kuzma, J. N., Schmidt, K. A., & Kratz, M. (2018) · Comprehensive Physiology · doi:10.1002/cphy.c170040 · Cited by 373
Metadata
- Authors
- Taylor, R., & Holman, R. R.
- Venue
- Clinical Science
- Publisher
- Portland Press Ltd.
- Published
- 2014-01-01
- Volume
- 128
- Issue
- 7
- Pages
- 405-410
- ISSN
- 0143-5221 (ISSN-L)
- 1470-8736
- OpenAlex
- W2059006486
- Cited by
- 190
- References
- 13
- FWCI
- 6.22
- Type
- journal article
- Language
- en
- Open access
- green
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