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In this issue of Diabetologia, Kang et al (DOI: 10.1007/s00125-012-2776-x ) provide evidence that in addition to glucotoxicity, lipotoxicity also affects incretin receptor expression and signalling in insulin-secreting cells and isolated islets

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This dramatic trend has a huge economic impact, estimated at $4 trillion in 2035 or 2.9% of global GDP, as a result of higher healthcare cost and lost economic productivity2