慢性高血糖狀態, 會引起一堆次發性變化 (這些次發性變化不是高血糖成因), 導致胰島素阻抗增加, 胰臟的b-cell 功能不良. 葡萄糖毒性 glucose toxicity 是指這些次發性不良反應
Once a state of chronic hyperglycaemia has been reached (diabetes), a number of secondary alterations take place that, although in themselves not the cause, do lead to an additional increase in both insulin resistance and b-cell dysfunction. The term glucose toxicity is used to refer to these secondary defects.
胰島素阻抗會降低病患對於胰島素的敏感度, 增加肝醣釋出, 同時產生血糖耐受性異常(glucose tolerance). 及高胰島素血症
高胰島素血症 ( hyperinsulinemia )
DM患者, 胰島素作用的標的器官對胰島素敏感度下降, 因此身體必須分泌更多胰島素以達成血糖平衡, 成因可能是臟器脂肪組織釋放過多脂肪酸, 進入門脈循環
胰島素阻抗現象 syndrome of insulin resistance)
高胰島素血症會增加糖尿病患的游離脂肪酸濃度, 形成脂質毒性作用 (lipotoxicity). 造成肥胖, 血脂異常, 高血壓, 動脈粥狀硬化
