Interdependence of hepatic lipid and glucose metabolism: novel pharmacological targets for diabetes.

Type 2 diabetes is a growing world epidemic which is fuelled by the increased prevalence of obesity, together with changes in lifestyle and nutritional habits. Current medical treatments for type 2 diabetes include stimulation of insulin secretion, inhibition of endogenous glucose production and enhancement of insulin sensitivity. However, more efficacious therapies are needed. Aberrations in the control of energy metabolism and substrate utilization are one of the hallmarks of insulin resistance and type 2 diabetes, and is reflected by tendencies of excessive accumulation of lipid products in tissues such as skeletal muscle, liver and the pancreatic islet beta-cell. Recent developments in understanding the interaction between carbohydrate and fatty acid metabolism may guide us to novel pharmacological targets in this area.