In male macaque monkeys aged 10 to 15 years, feeding a high-fat diet for 18 months is linked to a 17.86% rate of diabetes, as defined by elevated blood glucose and HbA1c levels, along with changes in...
Mechanism
Synthesis from 1 study
Too much fat over time makes the body stop burning sugar for energy and start making too much of it instead. This causes sugar to build up in the blood, leading to diabetes. Other changes in the liver and heart may make it worse, but the main problem is the broken balance between burning and making...
Most probable mechanism
When the body gets too much fat over a long time, its cells stop using sugar for energy efficiently, and instead start making more sugar from scratch. This happens because key enzymes needed to burn sugar in the mitochondria become less active, while another enzyme that helps build new sugar becomes more active. As a result, sugar builds up in the blood, leading to high glucose levels and long-term damage.
Chronic exposure to high levels of dietary fat reduces mitochondrial function in liver and muscle cells, decreasing the activity of citrate synthase and malate dehydrogenase 1.
Reduced citrate synthase and malate dehydrogenase 1 activity limits the flow of acetyl-CoA through the tricarboxylic acid cycle, impairing ATP production and the cell's ability to oxidize glucose.
Compensatory upregulation of hexose-6-phosphate dehydrogenase increases NADPH production via the pentose phosphate pathway, providing reducing power to fuel gluconeogenic reactions.
Enhanced gluconeogenic flux, combined with suppressed glucose oxidation, leads to excessive glucose production by the liver and sustained elevation of fasting blood glucose and glycated hemoglobin.
Less supported by current evidence, but not ruled out
Too much fat in the diet causes the liver to overproduce modified bile acids, which disrupts how fats are moved out of liver cells and triggers inflammation, making the liver less responsive to insulin.
Chronic high-fat intake increases bile acid conjugation in hepatocytes, elevating bile acid-CoA:amino acid N-acyltransferase activity.
Altered bile acid composition impairs farnesoid X receptor signaling, reducing lipid export and promoting intracellular lipid accumulation.
Lipid buildup and inflammatory signaling in the liver reduce insulin sensitivity and contribute to impaired glucose regulation.
Excess fat damages heart muscle cells by weakening their structural connections and signaling pathways, which may indirectly worsen whole-body metabolism through stress hormone release and reduced physical activity capacity.
Chronic lipid overload suppresses expression of proteins that link the cell membrane to the internal skeleton in heart muscle cells.
Loss of these structural proteins impairs mechanical sensing and survival signaling, leading to abnormal heart remodeling.
Cardiac dysfunction increases systemic metabolic stress, potentially amplifying insulin resistance and glucose dysregulation.
Evidence from Studies
Supporting (1)
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