The progression from normal glucose tolerance (NGT) to type 2 diabetes involves intermediate stages of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), also known as prediabetes. The pathophysiology underlying the development of these glucose metabolic alterations is multifactorial, leading to an alteration in the balance between insulin sensitivity and insulin secretion. Our knowledge of the molecular basis of the signaling pathways mediating the various physiologic effects of insulin is steadily advancing....
The growing worldwide epidemic of metabolic syndrome and other chronic degenerative
diseases continues to expand, with a rapid decrease in the age at which they are being
diagnosed (Guarnieri et al.; 2010; Hsueh & Wyne, 2011). Metabolic syndrome is a multifactorial
disorder, strongly influenced by several lifestyle factors, with symptoms clustering
on abnormalities that include obesity, hypertension, dyslipidemia, glucose intolerance and
insulin resistance (Guarnieri et al.; 2010; Tanaka et al.; 2006).
Although obese patients commonly have central obesity, hypertension, and glucose intolerance, they lack other specific stigmata of Cushing's syndrome (Chap. 336). Nonetheless, a potential diagnosis of Cushing's syndrome is often entertained. Cortisol production and urinary metabolites (17OH steroids) may be increased in simple obesity.