Type 2 diabetes mellitus: Isn’t it time to update the terminology?

Abstract

There is a paradigm shift in the approach to the treatment of type 2 diabetes mellitus (T2DM) based on recent research. “Twin cycle hypothesis” and remission of diabetes proved that diabetes is a disease due to excess fat accumulation above the personal fat threshold. Hence, weight reduction and, whenever possible, achievement of remission has become therapeutic target for the management of T2DM. Increasing evidence suggests that T2DM is a part of the spectrum of diseases caused by excess fat accumulation. Hence, it indeed is the need of the hour to update the terminologies to indicate that T2DM is part of the disease spectrum of excess fat accumulation to improve awareness among healthcare professionals and the public to achieve overall holistic management of the disease spectrum. In this short article, we analyze these factors and propose a new terminology for adaptation worldwide.

Keywords: Diabetes mellitus; Adiposity; Obesity; Personal fat threshold; Personal organ-specific fat threshold; Adiposity induced metabolic dysfunction associated diseases; Metabolic dysfunction associated hyperglycemic disease

Core Tip: Recent research has led to a paradigm shift in the treatment approach for type 2 diabetes mellitus (T2DM). The “twin cycle hypothesis” and evidence supporting diabetes remission have shown that the condition results from excess fat accumulation above the personal fat threshold. When excess fat deposition leads to organ dysfunction, we term it as adiposity-induced metabolic dysfunction associated disease. T2DM is a part of the spectrum of diseases caused by excess fat accumulation. Hence, it is the need of the hour to update the terminology and we propose a new terminology for T2DM. The proposed terminology is more reflective of the multifaceted nature of the disease, reshapes the management protocols and helps in earlier diagnosis and treatment.