Diabetes as the challenge to 21 century medicine--insights from clinical and biochemical investigations

The lifestyle changes characteristic to the second half of the 20 century, have evoked diabetes epidemic which drastically impairs the quality of life and is the underling cause of many demises, the most of which are related to the long term complications of the disease. Clinical investigations have established that gluco- and lipotoxicity are responsible for the progression and complications of diabetes and underscored the role of postprandial hypoglycemia in the pathogenesis of the disease. In recent years the clinical investigations were exploring the possibility of stopping the progression of 'prediabetic' state to overt diabetes, which is reveled as the late stage of a metabolic disorder which begins many years earlier and has deleterious effects on health. Biochemical investigations have revealed a large number of mechanisms responsible for the toxicity of high glucose and lipid concentrations, and pointed to mitochondria as the meeting place of pathogenic metabolic pathways.