Skip Navigation LinksHome > August 2008 - Volume 15 - Issue 4 > The accelerator hypothesis and increasing incidence of type...
Current Opinion in Endocrinology, Diabetes & Obesity:
doi: 10.1097/MED.0b013e3283073a5a
Diabetes and the endocrine pancreas II: Edited by Peter A. Gottlieb

The accelerator hypothesis and increasing incidence of type 1 diabetes

Fourlanos, Spiros; Harrison, Leonard C; Colman, Peter G

Collapse Box

Abstract

Purpose of review: To summarize the relevance of the ‘accelerator hypothesis’ to type 1 diabetes pathogenesis and examine if recent evidence supports the hypothesis. The ‘accelerator hypothesis’ proposes ‘three processes in type 1 diabetes which variably accelerate the loss of beta cells through apoptosis: constitution, insulin resistance and autoimmunity’.

Recent findings: Insulin resistance is an independent risk factor for progression to clinical type 1 diabetes in people with islet autoimmunity. Higher bodyweight is also associated with type 1 diabetes development although no longitudinal studies have simultaneously assessed bodyweight and insulin resistance in preclinical diabetes. Currently, there is no evidence for the view that accelerated beta-cell apoptosis is due to insulin resistance in the pathogenesis of type 1 diabetes.

Summary: Insulin resistance accelerates development of type 1 diabetes in people with islet autoimmunity and insulin deficiency. The increasingly ‘obesogenic’ environment which promotes insulin resistance could account for the rising incidence of type 1 diabetes.

© 2008 Lippincott Williams & Wilkins, Inc.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.