Roles of nutrition, obesity, and estrogens in diabetes mellitus: Human leads to an experimental approach to prevention

A review of diabetes mellitus is presented. Over 90% of adult-onset diabetes mellitus in the United States is due to “Westernized” diet while only 8% is due to genetic factors. The incidence of adult-onset diabetes mellitus is associated with dietary intake of fat, fiber, and sugar. High-fat, low-fiber diets stimulated the metabolic activity of the intestinal microflora and produced estrogens. Estrogens are significantly elevated in diabetic men. Amelioration of the hyperglycemia and diminished estrogen production appear responsible for the reversibility of the abnormalities seen in adult-onset diabetics. If one can prevent hyperglycemia and over nutrition during pregnancy, pre- and postnatal life, prophylaxis of juvenile-onset diabetes mellitus seems possible. An hypothesis is presented on how elevated plasma estrogens reversibly block the estradiol receptors in the liver, pituitary, and hypothalamus, cause hyperplasia of the β cells of the pancreas, and deterioration of glucose homeostasis leading to adult-onset diabetes mellitus.