6
Disease Categories
How Does Obesity (Adiposopathy) Cause Diabetes?
Adiposopathic Lipotoxicity and Diabetes
Liver and Muscle
Increased tissue FFA lead to
an increase in intracellular
binding of FFA to sphingolipids
forming "toxic" ceramides and its
metabolites:
• Mitochondrial dysfunction
• Endoplasmic reticulum "stress"
• Impaired insulin receptor
function
• Impaired glucose transporter
expression (glucose transporter
2 [GLUT2] for liver, GLUT4 for
muscle and adipose tissue)
Adipose Tissue
During positive caloric balance,
impaired uptake of energy in "sick"
adipose tissue leads to increased
circulating free fatty acids
and "ectopic" and pathogenic
deposition of fatty acids and fats:
• Visceral, pericardial, and
perivascular fat
• Fatty liver
• Fatty muscle
• Fatty heart
• Pancreas fat infiltration
Treatment of Adult Patients With Overweight or Obesity
Immunopathies
Endocrinopathies
Insulin resistance and
beta-cell dysfunction
Adiposopathic ("Sick Fat Disease")
