Editor’s Pick: How Can We Develop More Effective Strategies for Type 2 Diabetes Mellitus Prevention? A Paradigm Shift from a Glucose-Centric to a Beta Cell-Centric Concept of Diabetes

Abstract

Diabetes is defined as chronic hyperglycaemia due to insufficient insulin action. Over the last few decades, various different types of antidiabetic medications have been developed and the management of patients with Type 2 diabetes mellitus (T2DM) has been substantially improved. While we can now successfully control hyperglycaemia in patients with T2DM, the number of patients with T2DM continues to rise. In addition, the financial cost of T2DM is a worldwide problem and cost-effective strategies for T2DM prevention are eagerly awaited. To develop and establish more effective prevention strategies for T2DM, this paper proposes a paradigm shift from a glucose-centric to a beta cell-centric concept of T2DM management. This concept makes it easier for medical staff and patients to understand the process of the development of T2DM and its complications in a pathophysiology-based, continuous, and integrated manner; the glucose-centric concept has so far failed to emphasise the importance of intensive intervention before the onset of T2DM. It is hoped that this paradigm shift in the management of T2DM will foster the development of novel preventive strategies to effectively control this pandemic disease.