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Early
phase of diabetes mellitus may just
be a reversible insufficiency of
pancreas against excess fat tissue
Mehmet Rami
Helvaci1, Esma Helvaci2, Emine Helvaci2,
Yusuf Aydin1, Leyla Yilmaz Aydin3,
Alper Sevinc1, Celaletdin Camci1,
Abdulrazak Abyad4, Lesley Pocock5
1 Specialist of Internal Medicine,
MD, Turkey
2 Manager of Writing and Statistics,
Turkey
3 Specialist of Pulmonary Medicine,
MD, Turkey
4 Consultant, Internal Medicine
and Geriatric, Dar Al Shifa Hospital,
Kuwait Chairman, Middle-East Academy
for Medicine of Aging. President,
Middle East & North Africa Association
on Aging & Alzheimer’s
Coordinator, Middle-East Primary
Care Research Network, Coordinator,
Middle-East Network on Aging
5 medi-WORLD International, Australia
Correspondence:
Prof Dr Mehmet Rami Helvaci
07400, ALANYA, Turkey
Phone: 00-90-506-4708759
Email: mramihelvaci@hotmail.com
Received: October 2025. Accepted:
November 2025; Published: November/December
2025.Citation: Helvaci M R.. Early
phase of diabetes mellitus may just
be a reversible insufficiency of
pancreas against excess fat tissue.
World Family Medicine. November/December
2025; 23(8): 54 - 70. DOI: 10.5742/MEWFM.2025.805257
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Abstract
Background: Excess fat
tissue may be a reversible
etiology of early diabetes
mellitus (DM).
Methods:
Sickle cell diseases (SCD)
patients were studied.
Results:
We studied 222 males and 212
females (30.8 vs 30.3 years
of age, p>0.05, respectively).
Smoking (23.8% vs 6.1%, p<0.001),
alcohol (4.9% vs 0.4%, p<0.001),
transfused red blood cells
(RBC) in their lives (48.1
vs 28.5 units, p=0.000), disseminated
teeth losses (5.4% vs 1.4%,
p<0.001), ileus (7.2% vs
1.4%, p<0.001), stroke
(12.1% vs 7.5%, p<0.05),
chronic renal disease (CRD)
(9.9% vs 6.1%, p<0.05),
cirrhosis (8.1% vs 1.8%, p<0.001),
chronic obstructive pulmonary
disease (25.2% vs 7.0%, p<0.001),
coronary heart disease (18.0%
vs 13.2%, p<0.05), leg
ulcers (19.8% vs 7.0%, p<0.001),
and clubbing (14.8% vs 6.6%,
p<0.001) were all higher
in males.
Conclusion:
As a prototype of accelerated
atherosclerosis, hardened
RBC-induced capillary endothelial
cell damage terminates with
end-organ deficiencies in
early decades in SCD. Although
atherosclerotic endpoints
are so common, we detected
no case of DM probably due
to lower excess fat. As the
most common cause of CRD,
DM may be a reversible insufficiency
of pancreas against excess
fat tissue in early phases.
Increased blood and insulin
needs of excess fat in contrast
to decreased blood supply
of excess tissue and pancreas
both due to excess pressure
on vasculature, externally
and atherosclerosis, internally
may be important in DM. Acarbose
and metformin are safe, cheap,
oral, long-term used, and
effective drugs for excess
fat which may be curative
in early phases of DM before
development of other atherosclerotic
endpoints.
Key
words: Sickle cell diseases,
early diabetes mellitus, excess
fat tissue, acarbose, metformin,
capillary endothelial cell
inflammation, atherosclerotic
endpoints
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