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Lipid Metabolism & Diabetes

The lipid metabolism process is linked to the breakdown of carbohydrates and fat, both of which are fundamental elements of diabetes mellitus. Lipid metabolism occurs in the pancreas and many of the lipid metabolism steps are regulated by insulin. Insulin issues relating to both type 1 and type 2 diabetes can have a profound impact on the lipid metabolism process.

  1. What Are lipids

    • Lipids are an extensive group of molecules that includes fatty acids, vitamins, sterols and waxes among others. Because lipids encompass such a broad category, the body uses them in a number of ways and functions. As lipids are processed through the bloodstream, they go through a number of complex interactions depending upon their function and the body's energy and glucose requirements.

    Normal Lipid Metabolism

    • In normal lipid metabolism, the initial step is the hydrolysis of lipids to generate glycerol and fatty acids. Next, the glycerol is metabolized into an intermediate molecule, dihydroxyacetone phosphate, before being metabolized to either glucose for the blood or glycogen. Meanwhile, the fatty acids begin conversion to acetyl CoA and then are used for either fatty acid generation or they enter the citric acid cycles to be converted to ATP, carbon dioxide and water.

    Role of Insulin in Lipid Metabolism

    • It stands to reason that since insulin plays such an integral role in carbohydrate metabolism, it in turn also has impact on lipid metabolism, including the synthesis of fatty acids in the liver, breakdown of fat in adipose tissue, and fat-sparing effects. When excess sugar is present due to insulin deficiencies, the excess is stored in the body as triglycerides (a type of lipid) in adipose tissue.

    Lipid Metabolism in Type 1 Diabetes

    • Often patients with type 1 diabetes may have abnormalities associated with the body's use of lipids even if glycaemic control is maintained. Ultimately, the lack of insulin associated with type 1 diabetes, inhibits the body's ability to store lipids in adipose tissues and the lipids instead circulate as free fatty acids and lipoproteins. The free fatty acids are then oxidized by the liver and ketone bodies are formed. At elevated levels, ketones can increase the pH of blood or lead to ketoacidosis, which is when the body uses fat as a fuel source in the absence of sugar.

    Lipid Metabolism in Type 2 Diabetes

    • In type 2 diabetes, tissues fail to respond appropriately to insulin and leads to storage of the excess glucose energy in adipose tissue. These excess lipids accumulate in areas such as the liver, skeletal muscle and at time in the kidneys and pancreatic beta-cells. In type 2 diabetics, this process only enhances the weight gain and disregulation of sugar associated with the disease. In fact, for patients with an improperly regulated lipid metabolism process due to excess energy storage, type 2 diabetes may eventually develop.

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