One should know that type 2 DM is not only caused by beta cell dysfunction of pancreas. There are eight different organs of body involved in the pathophysiology of T2 DM.

1. Beta cells of pancreas, that they don’t produce enough insulin.

2. Alpha cells of pancreas produce disproportionately high glucagon as there is poor suppression of glucagon in the post meal phase, causing post prandial hyperglycemia.

3. Liver produces extra glucose causing high fasting blood glucose.

4. Skeletal muscles have poor uptake of glucose, which increases blood glucose.

5. Adipose tissue produces higher fatty acid.

6. Incretin hormone from intestine also show dysregulation (GLPl & GIP)

7. Kidney increase glucose reabsorption from proximal convoluted tubules

8. Brains satiety centers show dysregulation.

9. Thus, while treating a case of T2 DM, we should address all Eight Arms of, So called “Ominous Octet”.

Recorded at Akashwani Nagpur on the 30th August 2024

Anchor – Kalyani Gokhale

Speaker – Dr. Sunil Gupta