Chemistry and biochemistry of type 2 diabetes

The insulin signaling pathways have been the central focus in order to understand how insulin regulates hepatic glucose production and peripheral glucose utilization. Major advances have been made in the past decade. By binding to its receptor, insulin triggers a cascade of phosphorylation and activation events that lead to the activation of glucose transport and the suppression of hepatic glucose production. The defective regulation of these pathways by insulin in the disease state has been under intense scrutiny using animal models that mimic certain aspects of type 2 diabetes. These models, although with limitations, have been important tools in understanding the individual aspects of the disease and defining the pathways mediating insulin resistance. The new knowledge gained further advances the understanding of the pathophysiology of the disease so that better prevention and treatment approaches can be developed.