Chapter Ten THE ROLE OF INSULIN Flashcards
What is a common reason for the suppression of inconvenient evidence in medicine?
A subconscious desire to simplify a confusing subject.
This reflects the challenges faced by medical professionals in addressing complexities in their field.
Who identified dietary fat and cholesterol as causes of heart disease in the 1950s?
Ancel Keys.
Keys aimed to understand the disparity in disease rates among nations.
What term did Jean Vague use to describe excess fat around the waist?
Android obesity.
This condition is often exemplified by ‘beer bellies’.
What health issues did Jean Vague associate with android obesity?
- Atherosclerosis
- Gout
- Kidney stones
- Adult-onset diabetes
These associations hint at the potential metabolic consequences of obesity.
What did Vague speculate was a cause of obesity leading to diabetes?
Hormonal overactivity leading to overeating and increased insulin secretion.
This theory connects hormonal balance with metabolic disorders.
What did Margaret Albrink’s research in the 1930s conclude about high-fat diets for diabetics?
They did not increase cholesterol levels significantly.
Only a small percentage of extremely ill patients had abnormally high cholesterol.
What trend did Albrink observe in triglyceride levels among diabetics from the 1930s to the 1960s?
Average triglycerides increased by 40 percent.
This was accompanied by a rise in atherosclerotic complications among diabetics.
What did Albrink propose as a guiding principle for heart-disease research?
To understand the ‘abnormal metabolic patterns’ common to obesity, diabetes, and heart disease.
This shifted focus from traditional models to metabolic patterns.
What are the two insulin-related conditions that became a focus of inquiry?
- Insulin resistance
- Hyperinsulinemia
These conditions are crucial in understanding metabolic syndrome.
Who discovered a reliable method to measure insulin concentration in the blood?
Rosalyn Yalow and Solomon Berson.
Their work revolutionized diabetes research.
What surprising finding did Yalow and Berson discover about adult-onset diabetics?
They had significantly higher levels of circulating insulin than healthy individuals.
This contradicted the belief that diabetes was solely caused by a lack of insulin.
What is insulin resistance defined as?
A state in which greater-than-normal amounts of insulin are required to elicit a quantitatively normal response.
This condition complicates the management of blood sugar levels in diabetics.
What did Gerald Reaven’s research link together?
High triglycerides and glucose intolerance.
This suggested a common cause related to insulin resistance.
What was the first part of Reaven’s two-part hypothesis?
High triglycerides increase with carbohydrate-rich diets and decrease with fat-rich diets.
This relationship highlights the impact of diet on metabolic health.
What does Reaven’s second part of the hypothesis imply about carbohydrate-rich diets?
They increase the risk of heart disease in the presence of insulin resistance.
This underscores the connection between diet, insulin resistance, and cardiovascular risk.
What significant contribution did Ralph DeFronzo make in the study of insulin resistance?
He developed the ‘gold standard’ test for measuring insulin resistance.
His work advanced the understanding of metabolic syndrome.
What did Reaven propose in his Banting Lecture regarding metabolic syndrome?
It includes insulin resistance, hyperinsulinemia, high triglycerides, low HDL cholesterol, and high blood pressure.
This concept emphasizes the interconnectedness of these metabolic disorders.
What was a major obstacle in the study of metabolic syndrome according to DeFronzo?
The difficulty in measuring insulin resistance in clinical practice.
This complicates the diagnosis and understanding of metabolic disorders.
When did the National Cholesterol Education Program acknowledge Reaven’s Syndrome X?
In 2002.
The syndrome was renamed metabolic syndrome.
What misconception did many researchers hold regarding insulin’s relevance?
That it was only relevant to diabetes.
This limited the exploration of insulin’s role in heart disease.
What is the critical importance of insulin resistance and hyperinsulinemia in heart disease?
They were largely ignored by investigators focused on heart disease, who considered insulin relevant only to diabetes.
This oversight was a consequence of the specialization of scientific research.
What was the focus of Reaven’s research until the mid-1980s?
Diabetes and insulin, with publications primarily in journals of diabetes, endocrinology, and metabolism.
When did Reaven publish an article on Syndrome X in the journal Circulation?
1996.
What was the public health stance on insulin resistance and hyperinsulinemia in the late 1980s?
Neither the 1988 Surgeon General’s Report nor the 1989 Diet and Health report mentioned them, focusing instead on low-fat, high-carbohydrate diets for heart disease prevention.
