Nguyễn Kim Lương
Bệnh viện Đa khoa Trung ương Thái Nguyên
Mechanisms of insulin resistance
Impaired insulin sensisity, also termed insulin resistance, is then defined by reduced glucose clearance in skeletal muscle, impaired suppression of glucose production by the liver and lower rate of lipolysis by adipose tissue or by decreased combined action on whole body glucose disposal. The determination of insulin sensistivity from the glycemic response, creates conditions of constant insulin and glucose concentration, the rate of glucose production, insulin suppression of gluocse metabolism, systemic lipolysis in skeletal muscle, liver, adipose tissue. Results of studies show that: insulin resistance is the main factor for type 2 diabetes. It likely starts in the muscle. Muscle insulin resistance leads to alteratons postprandial energy deposition away from muscle glycogen toward hepatic de novo lipogenesis and dyslipidemia, hepatic lipid accumulation and hepatic insulin resistance eventually leading to non-alcoholic fatty liver disease and exessive fasting hepanic glucose production. This cellular lipid accumulation can occur by an imbalance between substrate delevery and removal from the insulin –responsive organs, causing defects/ disruption in insulin signaling.
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