Publications

Brown and beige adipose tissues (BAT and BeAT) are thermogenic fat depots that dissipate energy as heat via uncoupling protein-1 (UCP1) and complementary UCP1-independent mechanisms. Their activation increases whole-body substrate oxidation, improves insulin sensitivity, and modulates hepatic and skeletal-muscle metabolism through endocrine “batokines.” In humans, cold exposure and β-adrenergic stimulation acutely activate BAT, while repeated exposures drive the “browning” of white adipose tissue into beige adipocytes. Observational and interventional studies link higher BAT activity with lower fasting glucose, reduced triglycerides, and improved glucose tolerance, suggesting a role in preventing type 2 diabetes (T2D). This review summarizes the developmental origins and molecular control of BAT and beige fat, integrates evidence from animal and human studies on glucose homeostasis, and evaluates lifestyle, pharmacologic, and device-based strategies to activate thermogenic adipose tissue. We also address safety, feasibility, and knowledge gaps including heterogeneity of human BAT, durability of responses, and the need for clinically meaningful endpoints. Collectively, available data support BAT and beige adipose activation as a plausible, multifaceted approach to diabetes prevention, particularly when combined with diet and physical activity. However, translating mechanistic promise into population-level impact will require rigorous trials, standardized measurement, and long-term risk-benefit assessment.