insulin resistance

summary

Insulin resistance refers to a variety of reasons for insulin to promote glucose uptake and utilization efficiency decline, the body compensatory secretion of excessive insulin to produce hyperinsulinemia, in order to maintain the stability of blood glucose. Insulin resistance can easily lead to metabolic syndrome and type 2 diabetes. In the 1950s, yallow et al. Used radioimmunoassay to measure the plasma insulin concentration, and found that patients with lower plasma insulin level had higher insulin sensitivity, while those with higher plasma insulin level were not sensitive to insulin, so they put forward the concept of insulin resistance. Now let's briefly introduce the causes of insulin resistance.

insulin resistance

The first cause is hereditary factor. Structural abnormalities of insulin, the presence of insulin antibody, insulin receptor or gene mutation after insulin receptor (such as GLUT4 gene mutation, glucokinase gene mutation and insulin receptor substrate gene mutation, etc.).

Second, obesity. Obesity is the main cause of insulin resistance, especially central obesity. Obesity is mainly related to the lack of long-term exercise and excessive intake of dietary energy. 80% of patients with type 2 diabetes mellitus were diagnosed with obesity.

Third, disease and tumor necrosis factor-A (TNF-a) increased. Long term hyperglycemia, high free fatty acidemia, some drugs such as glucocorticoids, some trace element deficiency such as chromium and vanadium deficiency, pregnancy and increased insulin antagonistic hormone. Increased NF-A activity can promote lipolysis and increase the level of plasma free fatty acids, leading to insulin resistance and hyperinsulinemia

matters needing attention

In general, there is no effective treatment for primary or hereditary insulin resistance, but for some high-risk groups with insulin resistance, such as first-degree relatives with a family history of diabetes, people with a family history of hypertension and hyperlipidemia, low birth weight infants at birth or with a history of intrauterine malnutrition, we should pay special attention to avoid obesity in their postnatal life, so as to prevent pancreatic cancer as much as possible The occurrence of insular resistance. For the people who have shown insulin resistance, we should take different methods to reduce the factors that lead to or aggravate insulin resistance according to different people, and at the same time, we should carry out individualized treatment for different components of metabolic syndrome.