Modeling the progression of Type 2 diabetes with underlying obesity
Fig 2
Dynamics of glucose, insulin and functional beta-cell mass level for patient A with severe obesity (X approaches 1 progressively).
This figure depicts the impact of severe obesity on the glucose regulatory system. The pathogenic factor X initially overstimulates the beta-cell function of this patient. The insulin level exceeds 25 μU/ml after day 2631, which represents the onset of hyperinsulinemia. However, at this time, the glucose level is 102 mg/dl, which is close to normal. As X continuously increases, the functional beta-cell mass keeps rising before day 6089 and then decreases afterwards. Correspondingly, the insulin level retains increasing before day 7015 and then descends. The hyperinsulinemic stage ends after day 9373 and insulin deficiency gradually occurs afterwards. In the hyperinsulinemic stage, patient A experiences some fluctuations in the glucose levels. The glucose level exceeds the threshold of diabetic stage on day 6063, yet decreasing for a while after reaching the level 151 mg/dl on day 7134. Subsequent to the appearance of beta-cell failure and insulin deficiency, a sharp rise of the glucose level occurs, transitioning patient A to overt diabetes.