There is a growing epidemic of diabetes in the united states due largely to the marked increase in obesity. The link is indisputable. One of the problems with the treatment of diabetes is Resistance of the patient to insulin. This is due to many factors. Some of the reasons are listed below.
Insulin resistance: The diminished ability of cells to respond to the action ofinsulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. Insulin resistance typically develops with obesity and heralds the onset of type 2 diabetes. It is as if insulin is “knocking” on the door of muscle. The muscle hears the knock, opens up, and lets glucose in. But with insulin resistance, the muscle cannot hear the knocking of the insulin (the muscle is “resistant”). The pancreas makes more insulin, which increases insulin levels in the blood and causes a louder “knock.” Eventually, the pancreas produces far more insulin than normal and the muscles continue to be resistant to the knock. As long as one can produce enough insulin to overcome this resistance, blood glucose levels remain normal. Once the pancreas is no longer able to keep up, blood glucose starts to rise, initially after meals, eventually even in the fasting state. Type 2 diabetes is now considered to be overt.
Insulin resistance test
Fasting blood sugar levels:
- Normal: Less than 100 mg/dL
- Pre-diabetes: 100mg/dl – 125 mg/dL
- Diabetes: Greater than 125 mg/dL
Hemoglobin A1c is measured as a percent of blood sugar that binds to hemoglobin in red blood cells. It reflects the average blood sugar over the prior 2 -3 months.
- Normal: Less than 5.7%
- Pre-diabetes: 5.7 – 6.4%
- Diabetes: 6.5% or higher (on 2 separate blood tests)
Insulin resistance describes the body’s lack of sensitivity to the hormone insulin, meaning body cells such as the muscle, fat and liver cells are not adequately stimulated to take up glucose from
the blood, even when insulin levels are high. This under-utilization of blood glucose results in hyperglycemia or a raised blood sugar level. Tests for diagnosing insulin resistance include:
Fasting blood sugar and postprandial blood sugar – Blood sugar is almost always raised in people with insulin resistance.
Fasting insulin assessment – In a healthy person who has fasted for 6 to 8 hours (usually overnight), the insulin level is approximately 60 pmol/L. A level higher than this is considered indicative of insulin resistance.
Glucose tolerance testing (GTT) – For a glucose tolerance test, a person fasts for 8 to 12 hours (usually overnight) and is then given a 75 gram oral dose of glucose. After two hours, the blood levels of glucose are measured.
In a healthy person, the blood sugar level after two hours is usually less than 7.8 mmol/L (140 mg/dl). A blood sugar level between 7.8 and 11.0 mmol/dl (140 to 197 mg/dl), however, indicates impaired glucose tolerance. If the level is over 11.1 mmol/dl (200 mg/dl), diabetes mellitus is diagnosed.
Modified insulin suppression test – For this test, patients are given 25 mcg of octreotide (an inhibitor of insulin and glucagon) over 3 to 5 minutes and are then infused with somatostatin (0.27 μgm/m2/min) to suppress the release of insulin and glucose into the blood.
Next, the patient is administered insulin and 20% glucose and a series of blood sugar tests are then performed and the values averaged out to give the steady-state plasma glucose (SSPG) level. An SSPG greater than 150 mg/dl indicates insulin resistance.
Other measures of insulin resistance include the homeostatic model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI).
insulin resistance treatment
A new scientific discovery could just be the cure for Diabetes. The discovered treatment involves the blocking of VEGF-B, a protein that is responsible for the buildup of fat around the wrong places in the body, consequently causing the Type II Diabetes.
Professor Ulf Eriksson, head of the scientific research, carried out the research on mice at the Karolinska Institute, Sweden, the Ludwig Institute for Cancer Research, which is based in New York. Professor Ulf Eriksson said that the discovery represented a potential breakthrough in the treatment of Diabetes. “It’s a great feeling to present these results. We discovered VEGF-B back in 1995, and since then the VEGF-B project has been a lengthy sojourn in the wilderness, but now we’re making one important discovery after the other.”
The professor said that in their current study, they had shown that VEGF-B inhibition can be used to treat and even prevent type II Diabetes. He also stated that it could be done for drug candidates.
Type II diabetes occurs when a person becomes obese. Insulin resistance follows the obesity, after which diabetes comes. The cells fail to respond to insulin properly. The glucose does not enter the cells and blood glucose levels rise.
Diabetes type II is a common ailment posing a serious global concern. Analysts project that by 2030, over half a billion people will be living with the disease.
The experiment was carried out in mice. The researchers noted that diabetes induced mice given 2H10, an antibody that inhibits the actions of VEGF-B, did not develop insulin resistance, hence did not develop diabetes. The researcher also found that interbreeding these rats with those that could not naturally produce VEGF-B, the offspring of the two breeds of mice never developed diabetes.
The research could just be what scientists need in their experiments for finding the cure for diabetes.
insulin resistance weight gain
one in four adults are obese, compared to one in 10 in 1989. Since the mid-1990s men are on average 3.6 kilos heavier, women are four kilos heavier, and by one estimate obesity is costing the nation $60 billion a year.
Associate Professor John Dixon, from the Baker IDI Heart & Diabetes Institute in Melbourne, wants the Federal Government and the Australian Medical Association to label obesity a disease.
He’s part of a growing chorus of medical experts calling on governments to offer obese people more treatment options, including greater access to weight-loss surgery, drugs and diet plans.
“We are treating a chronic disease,” Associate Professor Dixon told ABC RN’s Health Report. “If we’ve got effective tools to treat a deadly and disabling disease, we should use them.”
Being overweight or obese is already linked to a range of diseases including type two diabetes, heart disease and a number of cancers. But is obesity itself a disease?
ABC Fact Check investigates.
body mass index, which is calculated by dividing weight in kilograms by height in metres squared. It says obesity is a BMI of greater than 30.
There is little doubt that weight loss is the single most effective way to combat insulin resistance. It can dramatically improve or reverse insulin resistance.
Diabetes and obesity are a national health issue. insulin resistance is an issue with the treatment and cause of the disease. New treatment and understanding of the mechanisms responsible for the development of the resistance will be most helpful.
Public domain image from Pixabay