Friday, November 12, 2021

Insulin resistance syndrome

The insulin resistance syndrome, also referred to as the ‘metabolic syndrome’ or ‘syndrome X’ has been broadly defined as “a state (of a cell, tissue, or organism) in which a greater than normal amount of insulin is required to elicit a quantitatively normal response.” Insulin resistance impairs glucose disposal, resulting in a compensatory increase in beta-cell insulin production and hyperinsulinemia.

Persons with the insulin resistance syndrome show higher all-cause mortality, cardiovascular disease (CVD), diabetes, hypertension, dyslipidemia, polycystic ovary syndrome (PCOS), and nonalcoholic steatohepatitis (NASH). The syndrome is likely to be very costly, with estimates that the related condition, obesity, leads to health costs in the U.S. of $100 billion yearly.

Because resistance usually develops long before these diseases appear, identifying and treating insulin resistant patients has potentially great preventive value.

Other abnormalities linked to insulin resistance include hyperuricemia, elevated levels of plasminogen activator inhibitor I and a preponderance of small-size, low-density lipoprotein particles.

Insulin resistance is influenced by both lifestyle and genetic background. Insulin is responsible for many other functions in addition to carbohydrate hemostasis such as: cellular growth and differentiation, protein synthesis, mRNA synthesis and etc.

Clinically, insulin resistance is recognized via the metabolic consequences associated with insulin resistance as described in metabolic syndrome and insulin resistance syndrome.

The gold standard for measurement of insulin resistance is the hyperinsulinemic-euglycemic glucose clamp technique.

Exercise training improves insulin sensitivity.Patients with suspected insulin resistance should be advised to increase their level of physical activity. Even regular, sustained, moderate increases in physical activity, such as daily walking, can substantially decrease insulin resistance.

The amount of dietary fiber consumed is inversely related to insulin levels. This observation may explain the lower incidence of hypertension, hyperlipidemia and cardiovascular disease among people with diets high in fiber.
Insulin resistance syndrome

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