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According to WHO estimates, eight percent of the population develop type 2 diabetes during the course of their lives. In Germany alone, more than six million people suffer from this metabolic disease. The number increases by about 400,000 new cases each year.
In type 2 diabetes, a permanently elevated blood glucose level causes damage in the body. At the beginning of the disease the pancreas usually still produces enough insulin. Muscle, liver and fat cells, however, become increasingly insensitive (insulin resistance) and are increasingly unable to absorb sufficient glucose from the blood – the blood glucose level remains elevated. The causes of this insulin resistance are risk factors such as overweight and obesity, a lifestyle with little physical activity, an unhealthy, high calorie, low-fiber diet, smoking, and an individual genetic predisposition.
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Various genetic and epigenetic changes play a role in the development of diabetes. These lead to different subtypes, which, among other features, are characterized by different mutations.
DZD scientists are developing personalized prevention and therapy approaches, that is, they are seeking to fit the right treatment at the right time for the various patient groups. The objective is to prevent or at least delay the emergence of type 2 diabetes and its complications by means of an individually coordinated intervention.
Focus of Research on Type 2 Diabetes
The research activities of the DZD in the field of type 2 diabetes focus on several main areas: The scientists are working to identify risk factors such as specific genetic predispositions and environmental influences. In addition, the aim of DZD research is to elucidate the molecular causes of diabetes. DZD scientists are also searching for new type 2 diabetes biomarkers, which shall aid in developing simple diagnostic laboratory procedures for the early diagnosis of diabetes. Another focus of diabetes research is to stop the destruction of insulin-producing beta cells. If the beta cells are destroyed, scientists are working on therapies that replace them: on the one hand through the transplantation of donor cells (islet cell transplantation) and on the other hand with the aid of stem cells.
In addition, the DZD scientists want to find out the role of the brain, the liver, the muscles and the pancreas in diabetic development and how organs interact with each other (organ crosstalk).
Furthermore, the DZD conducts multicenter studies on diabetes prevention (PLIS), on diabetes sequelae (DDS), on gestational diabetes (PREG) and on the prevention of type 1 diabetes (Pre-POINTearly). The objective of these studies is to develop personalized prevention and therapeutic measures.
Type 2 diabetes does not develop from one day to the next. Patients often go through longer preliminary stages in which the metabolism already begins to change. DZD researchers have been able to identify certain metabolic products and proteins in the blood which serve as biomarkers for these processes and possibly also cause them.
People with a disturbed glucose metabolism that have a preliminary stage of diabetes (prediabetes) have an increased risk for type 2 diabetes, cardiovascular disease, dementia and cancer. New analyses show that screening for fatty liver, increased abdominal fat and disruption of the production and effect of insulin can help to better predict and prevent the risk of cardiovascular disease and type 2 diabetes.
Causes, Diagnosis and Treatment