In the December issue of Diabetes Care, Barbara Corkey from Boston University examines the we way we understand and treat obesity and diabetes, and she concludes our thinking is flawed. Many believe that overeating and inactivity cause obesity. And consequently, obesity and insulin resistance cause diabetes. But Corkey proposes an alternative perspective, that insulin resistance may be a response to the real disease pathway for diabetes, rather than the primary cause.

Diabetes has increased dramatically from the world’s 15th cause of death to 9th in 20 years. Nearly 70,000 people die yearly as a result. Corkey, a nationally known researcher, points out that diabetes responds poorly to current treatment strategies. These facts lead her to conclude that our understanding of diabetes is inadequate.

In the absence of proof for insulin resistance causing diabetes, what alternative theories are worth testing? Corkey’s paper proposes several possibilities. The alternatives include defective hunger regulation, excessive increase in body fat buildup, mitochondrial DNA and epigenetic changes, and a defect in the insulin-secreting beta-cells. The culprits could be inadequately tested food additives or environmental chemical contaminants. Clearly, these observations call for a bold research agenda.

Click here to access the abstract of Corkey’s paper and here to read about Corkey’s work in BU Today.

Labyrinth Image © Tobias Rütten / Wikimedia Commons