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The worldwide pandemic of type 2 diabetes

The next two decades will bring a worldwide pandemic of type 2

diabetes. As many as 300 million people worldwide may have type 2

diabetes by the year 2025.

 Amos AF, c!arty "#, $immet %. The rising global b&rden of diabetes

and its complications' estimates and pro(ections to the year 20)0.

"iabet ed )**+)- /&ppl 5'/)1/5.

nternational "iabetes Federation. "iabetes Atlas 2000.

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054204)

The pathophysiology of hyperglycemia in type 2 diabetes involves threemain defects' ) ins&lin deficiency d&e to ins&fficient pancreatic ins&lin

release

2 excess hepatic gl&cose o&tp&t and 3 ins&lin resistance decreased

gl&cose &pta6e in peripheral tiss&es incl&ding m&scle and fat and the

liver.)13

Two pancreatic islet cell defects contrib&te to this pathology'

78eta cells prod&ce ins&lin, which facilitates gl&cose entry into tiss&es.-

n type 2 diabetes mellit&s, a decline in f&nctional beta1cell mass

ca&ses ins&lin deficiency, which in t&rn contrib&tes to

hyperglycemia.315

7  Alpha cells prod&ce gl&cagon. 9levated gl&cagon levels promote

increased hepatic gl&cose o&tp&t.)

n type 2 diabetes mellit&s, excess gl&cagon and diminished ins&lin

secretion drive hepatic gl&cose o&tp&t and contrib&te to

hyperglycemia.)

1/Buse, p 1429, C1, ¶3, L8-13,C2, ¶1, L11-16;p 1441, C2, ¶3, L1-3;p 1442, Fig 29-10 legendC1, ¶2, L2-4

2/Buchanan,

p B35, ¶1, L1-4

3/Powers,

p 2157, C1, ¶3, L1-3, 8-16

5/Rhodes,

p 383, C2, ¶1, L5-8

1/Buse, p 1429, C1,¶3, L8-132/Buchanan,

p B35, ¶1, L1-43/Powers,

p 2157, C1, ¶3,L1-3

4/Del Prato,

p 719, C2, L2-83/Powers,

p 2157,C1, ¶3, L11-16

4/Del Prato,p 719, C2, L8-125/Rhodes,

p 383,C2, ¶1, L5-8

6/Williams,

p 28, ¶2, L1-21/Buse, p 1442,Fig 29-10 legend,L2-5, C1, ¶2, L2-4

1/Buse, p 1442,C2, ¶2, L5-8C2, ¶2, L1-3,