Identifying the causative relationship between the fatty acid composition of cell membranes and type 2 diabetes
mellitus fundamentally contributes to the understanding of the basic pathophysiological mechanisms of the disease.
Important outcomes of the reviewed studies appear to support the hypotheses that the flexibility of a membrane
determined by the ratio of (poly)unsaturated to saturated fatty acyl chains of its phospholipids influences the
effectiveness of glucose transport by insulin-independent glucose transporters (GLUTs) and the insulin-dependent
GLUT4, and from the prediabetic stage on a shift from unsaturated towards saturated fatty acyl chains of membrane
phospholipids directly induces a decrease in glucose effectiveness and insulin sensitivity. In addition, it has become
evident that a concomitant increase in stiffness of both plasma and erythrocyte membranes may decrease the
microcirculatory flow, leading ultimately to tissue hypoxia, insufficient tissue nutrition, and diabetes-specific
microvascular pathology. As to the etiology of type 2 diabetes mellitus, a revised hypothesis that attempts to
accommodate the reviewed findings is presented.
Keywords: Cell Membranes, Erythrocyte Deformability, Glucose Effectiveness, Glucose Transporter, Insulin Sensitivity,
Phospholipids, Type 2 Diabetes Mellitus, Unsaturated Fatty Acid, insulin-dependent GLUT4, fatty acid
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