Insulin resistance

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Insulin resistance
MeSH C18.452.394.968.500

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Causes of insulin resistance

The cause of the vast majority of cases of insulin resistance remains unknown. However, insulin resistance might be caused by a high carbohydrate diet. Some physicians also believe that glucosamine (often prescribed for joint problems) may cause insulin resistance.

Therapy

The primary treatment for insulin resistance is exercise and weight loss. In some individuals, a low glycemic index or a low carbohydrate diet may also help. Fasting might also help. Both metformin and the thiazolidinediones improve insulin resistance, but are only approved therapies for type 2 diabetes, not insulin resistance, per se. By contrast, growth hormone replacement therapy may be associated with increased insulin resistance.[1]

The Diabetes Prevention Program showed that exercise and diet were nearly twice as effective as metformin at reducing the risk of progressing to type 2 diabetes.[2]

Some types of Monounsaturated fatty acids and saturated fats appear to promote insulin resistance, whereas some types of polyunsaturated fatty acids (omega 3) can increase insulin sensitivity.[3][4][5]

There are scientific studies showing that chromium picolinate can increase insulin sensitivity, especially in type 2 diabetics, but other studies show no effect. The results are controversial.

Naturopathic approaches to insulin resistance have been advocated including supplementation of vanadium, bitter melon (momordica) and Gymnema sylvestre.[6]

History

The concept that insulin resistance may be the underlying cause of diabetes mellitus type 2 was first advanced by Sir Harold Percival Himsworth of the University College Hospital Medical Center in London in 1936.[7]

References

  1. Bramnert M, Segerlantz M, Laurila E, Daugaard JR, Manhem P, Groop L (2003). "Growth hormone replacement therapy induces insulin resistance by activating the glucose-fatty acid cycle". THE JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM. 88 (4): 1455–1463. PMID 12679422.
  2. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group (2002). "Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin". New England Journal of Medicine. 346 (6): 393–403. PMID 11832527.
  3. Lovejoy, JC (2002). "The influence of dietary fat on insulin resistance". Current Diabetes Reports. 2 (5): 435&ndash, 440. PMID 12643169.
  4. Fukuchi S (2004). "Role of Fatty Acid Composition in the Development of Metabolic Disorders in Sucrose-Induced Obese Rats". Experimental Biology and Medicine. 229 (6): 486&ndash, 493. PMID 15169967.
  5. Storlien LH (1996). "Dietary fats and insulin action". Diabetologica. 39 (6): 621&ndash, 631. PMID 8781757.
  6. Harinantenaina L (2006). "Momordica charantia constituents and antidiabetic screening of the isolated major compounds". Chemical & Pharmaceutical Bulletin (Tokyo). 54 (7): 1017&ndash, 21. PMID 16819222.
  7. Himsworth HP (1936). "Diabetes mellitus: its differentiation into insulin-sensitive and insulin-insensitive types". Lancet. 1: 127&ndash, 130.

See also

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de:Insulinresistenz fi:Insuliiniresistenssi


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