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Diabetologia

Erschienen in:

01.01.2010 | Review

The global diabetes epidemic as a consequence of lifestyle-induced low-grade inflammation

verfasst von: H. Kolb, T. Mandrup-Poulsen

Erschienen in: Diabetologia | Ausgabe 1/2010

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Abstract

The recent major increase in the global incidence of type 2 diabetes suggests that most cases of this disease are caused by changes in environment and lifestyle. All major risk factors for type 2 diabetes (overnutrition, low dietary fibre, sedentary lifestyle, sleep deprivation and depression) have been found to induce local or systemic low-grade inflammation that is usually transient or milder in individuals not at risk for type 2 diabetes. By contrast, inflammatory responses to lifestyle factors are more pronounced and prolonged in individuals at risk of type 2 diabetes and appear to occur also in the pancreatic islets. Chronic low-grade inflammation will eventually lead to overt diabetes if counter-regulatory circuits to inflammation and metabolic stress are compromised because of a genetic and/or epigenetic predisposition. Hence, it is not the lifestyle change per se but a deficient counter-regulatory response in predisposed individuals which is crucial to disease pathogenesis. Novel approaches of intervention may target these deficient defence mechanisms.

Hauner H (2007) Diabetesepidemie und Dunkelziffer. In: Deutsche Diabetes Union (ed) Deutscher Gesundheitsbericht Diabetes. Kirchheim, Mainz, pp 7–12

Tasali E, Leproult R, Spiegel K (2009) Reduced sleep duration or quality: relationships with insulin resistance and type 2 diabetes. Prog Cardiovasc Dis 51:381–391CrossRefPubMed

Knol MJ, Twisk JW, Beekman AT, Heine RJ, Snoek FJ, Pouwer F (2006) Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia 49:837–845CrossRefPubMed

Kolb H, Mandrup-Poulsen T (2005) An immune origin of type 2 diabetes? Diabetologia 48:1038–1050CrossRefPubMed

Haubner F, Lehle K, Munzel D, Schmid C, Birnbaum DE, Preuner JG (2007) Hyperglycemia increases the levels of vascular cellular adhesion molecule-1 and monocyte-chemoattractant-protein-1 in the diabetic endothelial cell. Biochem Biophys Res Commun 360:560–565CrossRefPubMed

El Osta A, Brasacchio D, Yao D et al (2008) Transient high glucose causes persistent epigenetic changes and altered gene expression during subsequent normoglycemia. J Exp Med 205:2409–2417CrossRefPubMed

Dasu MR, Devaraj S, Jialal I (2007) High glucose induces IL-1beta expression in human monocytes: mechanistic insights. Am J Physiol Endocrinol Metab 293:E337–E346CrossRefPubMed

Devaraj S, Venugopal SK, Singh U, Jialal I (2005) Hyperglycemia induces monocytic release of interleukin-6 via induction of protein kinase c-α and -β. Diabetes 54:85–91CrossRefPubMed

Piconi L, Quagliaro L, Da Ros R et al (2004) Intermittent high glucose enhances ICAM-1, VCAM-1, E-selectin and interleukin-6 expression in human umbilical endothelial cells in culture: the role of poly(ADP-ribose) polymerase. J Thromb Haemost 2:1453–1459CrossRefPubMed

10.

Fung TT, McCullough ML, Newby PK et al (2005) Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 82:163–173PubMed

11.

Esposito K, Marfella R, Ciotola M et al (2004) Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292:1440–1446CrossRefPubMed

12.

Mohanty P, Hamouda W, Garg R, Aljada A, Ghanim H, Dandona P (2000) Glucose challenge stimulates reactive oxygen species (ROS) generation by leucocytes. J Clin Endocrinol Metab 85:2970–2973CrossRefPubMed

13.

Dickinson S, Hancock DP, Petocz P, Ceriello A, Brand-Miller J (2008) High-glycemic index carbohydrate increases nuclear factor-kappaB activation in mononuclear cells of young, lean healthy subjects. Am J Clin Nutr 87:1188–1193PubMed

14.

Esposito K, Nappo F, Marfella R et al (2002) Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 106:2067–2072CrossRefPubMed

15.

Manning PJ, Sutherland WH, Hendry G, de Jong SA, McGrath M, Williams SM (2004) Changes in circulating postprandial proinflammatory cytokine concentrations in diet-controlled type 2 diabetes and the effect of ingested fat. Diabetes Care 27:2509–2511CrossRefPubMed

16.

Kempf K, Rose B, Herder C et al (2007) The metabolic syndrome sensitizes leukocytes for glucose-induced immune gene expression. J Mol Med 85:389–396CrossRefPubMed

17.

Pfleger C, Mortensen HB, Hansen L et al (2008) Association of IL-1ra and adiponectin with C-peptide and remission in patients with type 1 diabetes. Diabetes 57:929–937CrossRefPubMed

18.

Maedler K, Sergeev P, Ris F et al (2002) Glucose-induced beta cell production of IL-1beta contributes to glucotoxicity in human pancreatic islets. J Clin Invest 110:851–860PubMed

19.

Maedler K, Sergeev P, Ehses JA et al (2004) Leptin modulates beta cell expression of IL-1 receptor antagonist and release of IL-1beta in human islets. Proc Natl Acad Sci USA 101:8138–8143CrossRefPubMed

20.

Boni-Schnetzler M, Thorne J, Parnaud G et al (2008) Increased interleukin (IL)-1beta messenger ribonucleic acid expression in beta -cells of individuals with type 2 diabetes and regulation of IL-1beta in human islets by glucose and autostimulation. J Clin Endocrinol Metab 93:4065–4074CrossRefPubMed

21.

Lambertucci RH, Hirabara SM, Silveira LR, Levada-Pires AC, Curi R, Pithon-Curi TC (2008) Palmitate increases superoxide production through mitochondrial electron transport chain and NADPH oxidase activity in skeletal muscle cells. J Cell Physiol 216:796–804CrossRefPubMed

22.

Laine PS, Schwartz EA, Wang Y et al (2007) Palmitic acid induces IP-10 expression in human macrophages via NF-kappaB activation. Biochem Biophys Res Commun 358:150–155CrossRefPubMed

23.

Yu HY, Inoguchi T, Kakimoto M et al (2001) Saturated non-esterified fatty acids stimulate de novo diacylglycerol synthesis and protein kinase c activity in cultured aortic smooth muscle cells. Diabetologia 44:614–620CrossRefPubMed

24.

Schenk S, Saberi M, Olefsky JM (2008) Insulin sensitivity: modulation by nutrients and inflammation. J Clin Invest 118:2992–3002CrossRefPubMed

25.

Aljada A, Mohanty P, Ghanim H et al (2004) Increase in intranuclear nuclear factor kappaB and decrease in inhibitor kappaB in mononuclear cells after a mixed meal: evidence for a proinflammatory effect. Am J Clin Nutr 79:682–690PubMed

26.

Esposito K, Nappo F, Giugliano F et al (2003) Meal modulation of circulating interleukin 18 and adiponectin concentrations in healthy subjects and in patients with type 2 diabetes mellitus. Am J Clin Nutr 78:1135–1140PubMed

27.

Tripathy D, Mohanty P, Dhindsa S et al (2003) Elevation of free fatty acids induces inflammation and impairs vascular reactivity in healthy subjects. Diabetes 52:2882–2887CrossRefPubMed

28.

Haus JM, Kashyap SR, Kasumov T et al (2009) Plasma ceramides are elevated in obese subjects with type 2 diabetes and correlate with the severity of insulin resistance. Diabetes 58:337–343CrossRefPubMed

29.

Pacheco YM, Lopez S, Bermudez B, Abia R, Villar J, Muriana FJ (2008) A meal rich in oleic acid beneficially modulates postprandial sICAM-1 and sVCAM-1 in normotensive and hypertensive hypertriglyceridemic subjects. J Nutr Biochem 19:200–205CrossRefPubMed

30.

Blackburn P, Despres JP, Lamarche B et al (2006) Postprandial variations of plasma inflammatory markers in abdominally obese men. Obesity (Silver Spring) 14:1747–1754CrossRef

31.

Nappo F, Esposito K, Cioffi M et al (2002) Postprandial endothelial activation in healthy subjects and in type 2 diabetic patients: role of fat and carbohydrate meals. J Am Coll Cardiol 39:1145–1150CrossRefPubMed

32.

Patel C, Ghanim H, Ravishankar S et al (2007) Prolonged reactive oxygen species generation and nuclear factor-kappaB activation after a high-fat, high-carbohydrate meal in the obese. J Clin Endocrinol Metab 92:4476–4479CrossRefPubMed

33.

Poppitt SD, Keogh GF, Lithander FE et al (2008) Postprandial response of adiponectin, interleukin-6, tumor necrosis factor-alpha, and C-reactive protein to a high-fat dietary load. Nutrition 24:322–329PubMed

34.

Schmitz G, Ecker J (2008) The opposing effects of n-3 and n-6 fatty acids. Prog Lipid Res 47:147–155CrossRefPubMed

35.

Cani PD, Neyrinck AM, Fava F et al (2007) Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia. Diabetologia 50:2374–2383CrossRefPubMed

36.

Shi H, Kokoeva MV, Inouye K, Tzameli I, Yin H, Flier JS (2006) TLR4 links innate immunity and fatty acid-induced insulin resistance. J Clin Invest 116:3015–3025CrossRefPubMed

37.

Milanski M, Degasperi G, Coope A et al (2009) Saturated fatty acids produce an inflammatory response predominantly through the activation of TLR4 signaling in hypothalamus: implications for the pathogenesis of obesity. J Neurosci 29:359–370CrossRefPubMed

38.

Poggi M, Bastelica D, Gual P et al (2007) C3H/HeJ mice carrying a toll-like receptor 4 mutation are protected against the development of insulin resistance in white adipose tissue in response to a high-fat diet. Diabetologia 50:1267–1276CrossRefPubMed

39.

Arkan MC, Hevener AL, Greten FR et al (2005) IKK-beta links inflammation to obesity-induced insulin resistance. Nat Med 11:191–198CrossRefPubMed

40.

Cai D, Yuan M, Frantz DF et al (2005) Local and systemic insulin resistance resulting from hepatic activation of IKK-beta and NF-kappaB. Nat Med 11:183–190CrossRefPubMed

41.

Aarnes M, Schonberg S, Grill V (2002) Fatty acids potentiate interleukin-1beta toxicity in the beta-cell line INS-1E. Biochem Biophys Res Commun 296:189–193CrossRefPubMed

42.

Lupi R, del Guerra S, Marselli L et al (2004) Rosiglitazone prevents the impairment of human islet function induced by fatty acids: evidence for a role of PPARgamma2 in the modulation of insulin secretion. Am J Physiol Endocrinol Metab 286:E560–E567CrossRefPubMed

43.

Kim EK, Kwon KB, Koo BS et al (2007) Activation of peroxisome proliferator-activated receptor gamma protects pancreatic beta-cells from cytokine-induced cytotoxicity via NF kappaB pathway. Int J Biochem Cell Biol 39:1260–1275CrossRefPubMed

44.

Grunnet LG, Aikin R, Tonnesen MF T et al (2009) Pro-inflammatory cytokines activate the intrinsic apoptotic pathway in β-cells. Diabetes 58:1807–1815CrossRefPubMed

45.

Maedler K, Spinas GA, Dyntar D, Moritz W, Kaiser N, Donath MY (2001) Distinct effects of saturated and monounsaturated fatty acids on beta-cell turnover and function. Diabetes 50:69–76CrossRefPubMed

46.

Herder C, Peltonen M, Koenig W et al (2009) Anti-inflammatory effect of lifestyle changes in the Finnish Diabetes Prevention Study. Diabetologia 52:433–442CrossRefPubMed

47.

North CJ, Venter CS, Jerling JC (2009) The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease. Eur J Clin Nutr 63:921–933CrossRefPubMed

48.

Cani PD, Possemiers S, van de Wiele T et al (2009) Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut 58:1091–1103CrossRefPubMed

49.

Uribarri J, Cai W, Sandu O, Peppa M, Goldberg T, Vlassara H (2005) Diet-derived advanced glycation end products are major contributors to the body’s AGE pool and induce inflammation in healthy subjects. Ann N Y Acad Sci 1043:461–466CrossRefPubMed

50.

Holick MF (2008) Diabetes and the vitamin D connection. Curr Diab Rep 8:393–398CrossRefPubMed

51.

Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW Jr (2003) Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest 112:1796–1808PubMed

52.

Xu H, Barnes GT, Yang Q et al (2003) Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 112:1821–1830PubMed

53.

Kintscher U, Hartge M, Hess K et al (2008) T-lymphocyte infiltration in visceral adipose tissue: a primary event in adipose tissue inflammation and the development of obesity-mediated insulin resistance. Arterioscler Thromb Vasc Biol 28:1304–1310CrossRefPubMed

54.

Hamdy O, Porramatikul S, Al Ozairi E (2006) Metabolic obesity: the paradox between visceral and subcutaneous fat. Curr Diabetes Rev 2:367–373PubMed

55.

Strissel KJ, Stancheva Z, Miyoshi H et al (2007) Adipocyte death, adipose tissue remodeling, and obesity complications. Diabetes 56:2910–2918CrossRefPubMed

56.

Velloso LA, Araujo EP, de Souza CT (2008) Diet-induced inflammation of the hypothalamus in obesity. Neuroimmunomodulation 15:189–193CrossRefPubMed

57.

Clement K, Viguerie N, Poitou C et al (2004) Weight loss regulates inflammation-related genes in white adipose tissue of obese subjects. FASEB J 18:1657–1669CrossRefPubMed

58.

Puglisi MJ, Fernandez ML (2008) Modulation of C-reactive protein, tumor necrosis factor-alpha, and adiponectin by diet, exercise, and weight loss. J Nutr 138:2293–2296CrossRefPubMed

59.

Beasley LE, Koster A, Newman AB et al (2009) Inflammation and race and gender differences in computerized tomography-measured adipose depots. Obesity (Silver Spring) 17:1062–1069CrossRef

60.

Chandalia M, Cabo-Chan AV Jr, Devaraj S, Jialal I, Grundy SM, Abate N (2003) Elevated plasma high-sensitivity C-reactive protein concentrations in Asian Indians living in the United States. J Clin Endocrinol Metab 88:3773–3776CrossRefPubMed

61.

Muller S, Martin S, Koenig W et al (2002) Impaired glucose tolerance is associated with increased serum concentrations of interleukin 6 and co-regulated acute-phase proteins but not TNF-alpha or its receptors. Diabetologia 45:805–812CrossRefPubMed

62.

Burkart V, Kim YE, Hartmann B et al (2002) Cholera toxin B pretreatment of macrophages and monocytes diminishes their proinflammatory responsiveness to lipopolysaccharide. J Immunol 168:1730–1737PubMed

63.

Lumeng CN, Deyoung SM, Saltiel AR (2007) Macrophages block insulin action in adipocytes by altering expression of signaling and glucose transport proteins. Am J Physiol Endocrinol Metab 292:E166–E174CrossRefPubMed

64.

Li L, Yang G, Shi S, Yang M, Liu H, Boden G (2009) The adipose triglyceride lipase, adiponectin and visfatin are downregulated by tumor necrosis factor-alpha (TNF-alpha) in vivo. Cytokine 45:12–19CrossRefPubMed

65.

Okada T, Liew CW, Hu J et al (2007) Insulin receptors in beta-cells are critical for islet compensatory growth response to insulin resistance. Proc Natl Acad Sci USA 104:8977–8982CrossRefPubMed

66.

Palmer JP, Helqvist S, Spinas GA, Molvig J, Mandrup-Poulsen T, Andersen HU, Nerup J (1989) Interaction of beta-cell activity and IL-1 concentration and exposure time in isolated rat islets of Langerhans. Diabetes 38:1211–1216CrossRefPubMed

67.

Donath MY, Storling J, Berchtold LA, Billestrup N, Mandrup-Poulsen T (2008) Cytokines and beta-cell biology: from concept to clinical translation. Endocr Rev 29:334–350CrossRefPubMed

68.

Kahn SE, Zraika S, Utzschneider KM, Hull RL (2009) The beta cell lesion in type 2 diabetes: there has to be a primary functional abnormality. Diabetologia 52:1003–1012CrossRefPubMed

69.

Peterson JM, Pizza FX (2009) Cytokines derived from cultured skeletal muscle cells after mechanical strain promote neutrophil chemotaxis in vitro. J Appl Physiol 106:130–137CrossRefPubMed

70.

Yuen DY, Dwyer RM, Matthews VB et al (2009) Interleukin-6 attenuates insulin-mediated increases in endothelial cell signaling but augments skeletal muscle insulin action via differential effects on tumor necrosis factor-alpha expression. Diabetes 58:1086–1095CrossRefPubMed

71.

Mathur N, Pedersen BK (2008) Exercise as a mean to control low-grade systemic inflammation. Mediators Inflamm 2008:109502. doi:10.1155/2008/109502 CrossRefPubMed

72.

Silva LA, Silveira PC, Pinho CA, Tuon T, Dal Pizzol F, Pinho RA (2008) N-acetylcysteine supplementation and oxidative damage and inflammatory response after eccentric exercise. Int J Sport Nutr Exerc Metab 18:379–388PubMed

73.

Huey KA, McCusker RH, Kelley KW (2008) Exaggerated expression of skeletal muscle-derived interleukin-6, but not TNFalpha, in mice lacking interleukin-10. J Neuroimmunol 199:56–62CrossRefPubMed

74.

Meier-Ewert HK, Ridker PM, Rifai N et al (2004) Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol 43:678–683CrossRefPubMed

75.

Irwin MR, Wang M, Ribeiro D et al (2008) Sleep loss activates cellular inflammatory signaling. Biol Psychiatry 64:538–540CrossRefPubMed

76.

Maraldi C, Volpato S, Penninx BW et al (2007) Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: the health, aging, and body composition study. Arch Intern Med 167:1137–1144CrossRefPubMed

77.

Pulkki-Raback L, Elovainio M, Kivimaki M et al (2009) Depressive symptoms and the metabolic syndrome in childhood and adulthood: a prospective cohort study. Health Psychol 28:108–116CrossRefPubMed

78.

Howren MB, Lamkin DM, Suls J (2009) Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 71:171–186CrossRefPubMed

79.

Raison CL, Borisov AS, Majer M et al (2009) Activation of central nervous system inflammatory pathways by interferon-alpha: relationship to monoamines and depression. Biol Psychiatry 65:296–303CrossRefPubMed

80.

McAfoose J, Baune BT (2009) Evidence for a cytokine model of cognitive function. Neurosci Biobehav Rev 33:355–366CrossRefPubMed

81.

Su S, Miller AH, Snieder H et al (2009) Common genetic contributions to depressive symptoms and inflammatory markers in middle-aged men: the Twins Heart Study. Psychosom Med 71:152–158CrossRefPubMed

82.

Tousoulis D, Drolias A, Antoniades C et al (2009) Antidepressive treatment as a modulator of inflammatory process in patients with heart failure: effects on proinflammatory cytokines and acute phase protein levels. Int J Cardiol 134:238–243CrossRefPubMed

83.

Larsen CM, Faulenbach M, Vaag A et al (2007) Interleukin-1-receptor antagonist in type 2 diabetes mellitus. N Engl J Med 356:1517–1526CrossRefPubMed

84.

Berchtold LA, Larsen CM, Vaag A et al (2009) IL-1 receptor antagonism and muscle gene expression in patients with type 2 diabetes. Eur Cytokine Netw 20:81–87PubMed

85.

Larsen CM, Faulenbach M, Vaag A, Ehses JA, Donath MY, Mandrup-Poulsen T (2009) Sustained effects of interleukin-1-receptor antagonist treatment in type 2 diabetes mellitus. Diabetes Care 32:1663–1668CrossRefPubMed

86.

Aksentijevich I, Masters SL, Ferguson PJ et al (2009) An autoinflammatory disease with deficiency of the interleukin-1-receptor antagonist. N Engl J Med 360:2426–2437CrossRefPubMed

87.

Channual J, Wu JJ, Dann FJ (2009) Effects of tumor necrosis factor-alpha blockade on metabolic syndrome components in psoriasis and psoriatic arthritis and additional lessons learned from rheumatoid arthritis. Dermatol Ther 22:61–73CrossRefPubMed

88.

Cheung D, Bryer-Ash M (2009) Persistent hypoglycemia in a patient with diabetes taking etanercept for the treatment of psoriasis. J Am Acad Dermatol 60:1032–1036CrossRefPubMed

89.

Manco M, Fernandez-Real JM, Equitani F et al (2007) Effect of massive weight loss on inflammatory adipocytokines and the innate immune system in morbidly obese women. J Clin Endocrinol Metab 92:483–490CrossRefPubMed

90.

Fleischman A, Shoelson SE, Bernier R, Goldfine AB (2008) Salsalate improves glycemia and inflammatory parameters in obese young adults. Diabetes Care 31:289–294CrossRefPubMed

91.

Fernandez-Real JM, Lopez-Bermejo A, Ropero AB et al (2008) Salicylates increase insulin secretion in healthy obese subjects. J Clin Endocrinol Metab 93:2523–2530CrossRefPubMed

92.

Koska J, Ortega E, Bunt JC et al (2009) The effect of salsalate on insulin action and glucose tolerance in obese non-diabetic patients: results of a randomised double-blind placebo-controlled study. Diabetologia 52:385–393CrossRefPubMed

93.

Hundal RS, Petersen KF, Mayerson AB, Randhawa PS, Inzucchi S, Shoelson SE, Shulman GI (2002) Mechanism by which high-dose aspirin improves glucose metabolism in type 2 diabetes. J Clin Invest 109:1321–1326PubMed

94.

Hotamisligil GS, Erbay E (2008) Nutrient sensing and inflammation in metabolic diseases. Nat Rev Immunol 8:923–934CrossRefPubMed

95.

Franceschi C, Capri M, Monti D et al (2007) Inflammaging and anti-inflammaging: a systemic perspective on aging and longevity emerged from studies in humans. Mech Ageing Dev 128:92–105CrossRefPubMed

96.

Dasu MR, Devaraj S, Zhao L, Hwang DH, Jialal I (2008) High glucose induces toll-like receptor expression in human monocytes: mechanism of activation. Diabetes 57:3090–3098CrossRefPubMed

97.

Schaeffler A, Gross P, Buettner R et al (2009) Fatty acid-induced induction of Toll-like receptor-4/nuclear factor-kappaB pathway in adipocytes links nutritional signalling with innate immunity. Immunology 126:233–245CrossRefPubMed

98.

Chao W (2009) Toll-like receptor signaling: a critical modulator of cell survival and ischemic injury in the heart. Am J Physiol Heart Circ Physiol 296:H1–H12CrossRefPubMed

99.

Ohashi K, Burkart V, Flohe S, Kolb H (2000) Cutting edge: heat shock protein 60 is a putative endogenous ligand of the toll-like receptor-4 complex. J Immunol 164:558–561PubMed

100.

Kim HJ, Higashimori T, Park SY et al (2004) Differential effects of interleukin-6 and -10 on skeletal muscle and liver insulin action in vivo. Diabetes 53:1060–1067CrossRefPubMed

Titel: The global diabetes epidemic as a consequence of lifestyle-induced low-grade inflammation
verfasst von: H. Kolb
T. Mandrup-Poulsen
Publikationsdatum: 01.01.2010
Verlag: Springer-Verlag
Erschienen in: Diabetologia / Ausgabe 1/2010
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-009-1573-7

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