Lipotoxicity and glucotoxicity may both be implicated in the pathogenesis o
f type 2 diabetes. Excess circulating fat, glucose, or both act on diverse
cells and tissues to counteract insulin-mediated glucose uptake, hepatic re
gulation of glucose output, and insulin secretion. In this article, Dr Sivi
tz reviews the biochemistry and clinical implications of these conditions a
nd how to manage them through lifestyle modifications.