Insulin resistance

Insulin is a protein hormone that lowers blood sugar in our body. It is an effective substance for treating diabetes and can effectively regulate the metabolic process in our body. It can effectively promote our body's absorption and utilization of glucose. Diabetic patients also need to use insulin in moderation to treat the disease. Excessive dependence may cause discomfort. Insulin resistance reduces the body's absorption and utilization of glucose.

Genetic factors and many environmental factors may cause insulin resistance, especially obesity. Long-term lack of exercise or excessive food intake are very harmful to the body. In daily life, we should pay attention to preventing insulin resistance, do some physical exercise, control diet, and diabetics should pay attention to controlling blood sugar.

Based on the insulin dose-response curve, it can be seen that there are three forms of insulin resistance:

(1) A rightward shift of the simple curve indicates that the insulin effector organ is less sensitive to insulin and an increase in the insulin dose is required to achieve the maximum response.

(2) Simply decreasing the curve height and increasing the insulin dose cannot reach the maximum response height, which indicates that the target organ's responsiveness to insulin is reduced.

(3) At the same time, the curve shifts to the right and the maximum height of the curve decreases, indicating that both insulin sensitivity and responsiveness are reduced.

There are many causes of insulin resistance, including genetic factors or primary insulin resistance, such as structural abnormalities of insulin, the presence of insulin antibodies in the body, insulin receptors or gene mutations behind insulin receptors (such as Glut4 gene mutations, glucose kinase gene mutations and insulin receptor substrate gene mutations, etc.). Primary insulin resistance is mostly caused by multiple gene mutations, and often multiple gene mutations work together to cause insulin resistance. In addition to the above-mentioned genetic factors, many environmental factors also participate in or cause insulin resistance, which is called secondary insulin resistance, such as obesity (the main cause of insulin resistance, especially central obesity; this is mainly related to long-term lack of exercise and excessive dietary energy intake. 80% of patients with type 2 diabetes are accompanied by obesity when diagnosed), long-term hyperglycemia, hyperlipidemia, certain drugs such as glucocorticoids, certain trace element deficiencies such as chromium and vanadium deficiency, pregnancy and increased insulin antagonist hormones in the body.

Tumor necrosis factor-a (TNF-a) increases. Enhanced TNF-a activity can promote lipolysis, causing an increase in plasma FFA levels, inhibit the activity of tyrosine kinase of muscle tissue insulin receptors, inhibit the phosphorylation of IRS-1 and the expression of Glut4, thereby leading to insulin resistance and hyperinsulinemia. In recent years, it has been discovered that adipocytes can secrete resistin, which can reduce glucose uptake after insulin stimulation. After resistin is neutralized, tissue glucose uptake increases. Other factors such as leptin resistance and decreased levels or activity of adiponectin are also associated with insulin resistance. Increased triglyceride (TG) content in skeletal muscle cells is also considered to be one of the causes of insulin resistance. Excessive accumulation of TG in B cells can cause their functional impairment.

In daily life, diabetics should pay attention to the rational selection of anti-glycemic drugs. Insulin should be injected under the guidance of a doctor. They should not rely too much on insulin, which will have a negative impact on the body. They should also rationally choose antihypertensive drugs and pay attention to replenishing trace elements in the body. Insulin resistance can also cause a variety of complications, so it should be treated as early as possible.