News & Comment

The relationship between type 2 diabetes mellitus (T2DM), insulin resistance and central obesity is not uniformly applicable to populations worldwide. In this Comment, we discuss the challenge of establishing waist circumference thresholds to predict T2DM in Africa.

For a person with type 1 diabetes mellitus, lifelong insulin treatment is the only therapeutic option. However, increased blood levels of glucose are just a symptom of impaired β-cell function. Approaching the centenary of the first insulin injection, broadening of international therapeutic guidelines to improve diagnostics, as well as monitor and preserve β-cell function, is warranted.

Emerging evidence demonstrates that an increasing number of novel medications have considerable potential to induce adrenal insufficiency. This condition might lead to acute adrenocortical insufficiency, which is potentially fatal; however, the condition could be avoided if clinicians are more aware of the new findings and their implications.

The Chinese Famine has been widely interpreted as an important contributor to subsequent epidemics of type 2 diabetes mellitus. Our re-examination of available studies challenges this apparent relationship. The definition of famine exposure and control selection needs more attention in future studies to better understand this potential association.

Type 2 diabetes mellitus is common, disabling and expensive, despite improved glucose-lowering management and guidelines. Its dominant cause is weight gain, with ectopic fat accumulation in vital organs, reflected by a large waist circumference. Addressing the underlying cause, by low-calorie formula diets and integrated support for long-term weight-loss maintenance, produces remissions in almost half the treated population.