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Adipose tissue as a culprit: How obesity leads to diabetes

A row of burgers with fatty filling
A high-fat diet leads to obesity and the development of diabetes. (Photo: Pexels)

A research team at the University of Basel has discovered that a high-fat diet alters the function of adipose tissue, thus impairing its ability to regulate blood sugar. This explains why a high-fat diet poses a significant health risk, particularly for diabetes.

28 March 2023 | Katrin Bühler and Heike Sacher

A row of burgers with fatty filling
A high-fat diet leads to obesity and the development of diabetes. (Photo: Pexels)

Diabetes is a medical condition in which the body is unable to keep blood sugar in a healthy range. Normally, the pancreas produces sufficient insulin to regulate the blood sugar level and maintain homeostasis. However, in diabetics, the body has lost this ability, leading to hyperglycemia.

Blood sugar levels that are persistently too high can cause long-term damage to blood vessels and lead to severe complications such as blindness or kidney failure. It has been known for some time that obese patients are particularly at risk of developing type 2 diabetes and that adipose tissue plays a critical role in the onset of the disease. In their recent study, researchers led by Professor Michael N. Hall at the Biozentrum, University of Basel, revealed how a high-fat diet triggers diabetes.

A high-fat diet not only leads to an excessive formation of adipose tissue but also impairs this tissue’s ability to regulate blood sugar levels. This is due to an insufficient production of the enzyme hexokinase 2, which normally plays a critical role in the disposal of sugar by adipose tissue. Consequently, the body develops insulin resistance, which means that it cannot efficiently use insulin for the uptake of sugar from the blood into the cells. 

Diabetes as a result of enzyme loss

The high-fat diet induced loss of hexokinase 2 leads to reduced sugar disposal in adipose tissue and disturbed sugar metabolism in the liver. The liver produces more sugar than in normal-weight individuals on a healthy diet. The combined effect of these metabolic changes in the two tissues inevitably leads to permanently elevated blood sugar levels and ultimately to diabetes.

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