Insulin Resistance Flashcards
what does insulin resistance mean
when organs are unresponsive to insulin
give some examples of diseases that can be caused by insulin resistance
T2DM, Alzheimer’s, HF, liver disease, hypertension
how is insulin resistance diagnosed
no symptoms, if risk factors present blood glucose levels should be tested for pre-diabetes and diabetes
what are some of the risk factors for insulin resistance
obesity, sedentary life, FH of diabetes, genetics, gestational diabetes, hypertension
what mechanism of insulin resistance is seen in skeletal muscle
impairment of insulin signalling
describe the mechanism of insulin resistance seen in adipose tissue
inflammation(usually obesity-induced inflammation), causes JNK and NF-kB activation, translates to produce pro-inflammatory cytokines, causes local insulin resistance and decreased insulin uptake
what mechanism of insulin resistance is seen in the liver
pathway-selective hepatic insulin resistance
what is the gold standard of measuring insulin sensitivity
hyperinsulinemic-euglycemic clamp
where are the 2 catheters used for the hyperinsulinemic-euglycemic clamp placed
one in jugular vein for infusion, one in carotid artery for blood sample
what is the aim of the hyperinsulinemic-euglycemic clamp
to maintain blood glucose level at normal, and to raise + maintain higher insulin level
how does the amount of glucose infused in the hyperinsulinemic-euglycemic clamp relate to insulin resistance
the greater the amount of glucose needed to keep it at normal glucose level, the more insulin resistant the patient
why is potassium phosphate infused in the hyperinsulinemic-euglycemic clamp
to prevent hypophasphatemia, added to IV fluids and given to patients who cannot eat or drink
what can you measure using a whole body insulin sensitivity test
glucose infusion rate(GIR) and glucose turnover rates(Ra and Rd)
what can you measure from a hepatic insulin sensitivity test
endogenous glucose production rate(EndoRa-GIR)
what do Ra and Rd mean
Ra = rate of appearance Rd = rate of disappearance
