Pathophysiology of insulin resistance sciencedirect. Study guide for understanding pathophysiology this page intentionally left blank study guide for understanding pathophysiology sue e. The cells are resistant to insulins signal to take up glucose, but higher levels get the job done. The formation of stones in the urinary tract stems from a wide range of underlying disorders. Insulin resistance refers to reduced insulin action in metabolic and vascular target tissues, hence higher than normal concentration of insulin is required to maintain normoglycemia and other actions of insulin, hence it may be considered as a euglycemic prediabetic state. Insulin resistance is a feature of a number of clinical disorders, including type 2 diabetesglucose intolerance, obesity, dyslipidaemia and hypertension clustering in the socalled metabolic syndrome. With insulin resistance, circulating levels of insulin are elevated but glucose stays normal. Extensively updated content reflects advances in pathophysiology including tumor biology invasion and metastases, the epidemiology of cancer, diabetes mellitus, insulin resistance, thyroid and adrenal gland disorders, female reproductive disorders including benign breast diseases and breast cancer, and a separate chapter on male reproductive. Major pathophysiology in prediabetes and type 2 diabetes. By the time we diagnose diabetes, insulin resistance is essentially at or almost at a peak, and stays at that level for the rest of that patients life unless we include a strategy in our. Pathophysiology of carbohydrates and proteins metabolism. Insulin resistance describes when the body produces insulin but the usual actions of insulin are not mediated. Newer definitions have to consider worsening of oxygenation, in addition to purulent respiratory secretions, chestx rays opacities, and. Mccance, msn, phd professor college of nursing university of utah salt lake city, utah section editors valentina l.
Comprehensive summaries of uppsala dissertations from the faculty of. Insulin stimulates glucose uptake into tissues, and its ability to do so varies greatly among individual persons. Insulin resistance can be defined as the failure of insulin sensitive cells to respond to insulin normally. Instead, the triglycerides in fat or adipose cells are broken down to provide free fatty acids as the energy source. Insulin resistance has also been arbitrarily defined as the requirement of 200 or more units of insulin per day to attain glycemic control and to prevent ketosis.
Insulin resistance is already well established when impaired glucose tolerance is present and the increase in glucose, even across the normal range, is due to a continuous decline in. In type 2 diabetes, there is increased insulin resistance, abnormal secretion of insulin by the beta cells, and increased glucose production by the liver. Objectiveto determine in diabetes whether hyperinsulinnemia develops first or insulin resistance develops first. At rest in the fasting state, the brain consumes about 80% of the glucose utilized by the whole body, but brain glucose uptake is not regulated by insulin. Start studying porth essentials of pathophysiology unit 6. In patients without nodat, insulin sensitivity, as evaluated by the homoeostatic model. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
Winner of the standing ovation award for best powerpoint templates from presentations magazine. Insulin resistance in skeletal muscle manifests itself primarily as a reduction in insulinstimulated glycogen synthesis, which is in turn a consequence of reduced glucose transport. It is characterized by elevated plasma glucose and, before attrition of pancreatic. A coding region l55m snp showed association with pcos. Disease prevention paper hcs436 april 29, 2014 maria libano disease prevention and description about the kidneys there is a common saying that the body is a one way street, therefore any alteration can hinder the flow and may cause damage to vital body systems and organs. Glucose is the main fuel for the brain, so that brain function critically. Insulin resistance plays a major role in the pathogenesis of type 2 diabetes and the metabolic syndrome. In people with insulin resistance, the muscles, fat and liver cells fail to respond to insulin in this way and glucose remains in the blood rather than being taken up, even when insulin levels are. For example, patients with type 2 diabetes who present in dka will typically require a higher dose of insulin than those with type 1 diabetes because of higher insulin resistance. Pathophysiology of type 2 diabetes and its treatment policy. Initially, there is an increased amount of insulin secretion stimulated by the insulin resistance of the body gro146. Dopamine d2 receptors in the pathophysiology of insulin. Ppt insulin resistance syndrome powerpoint presentation. Gerasymchuk pathophysiology department, ivano frankivsk national medical university.
While the euglycaemic insulin clamp technique is the goldstandard technique to diagnose insulin resistance in the research setting, it is complicated, invasive and costly, and rarely used in clinical practice. Pathophysiology of insulin resistance in human disease. In type 2 diabetes there is increased insulin resistance. Insulin resistance syndrome american family physician. There are many advances in genetics, pathophysiology, diagnostic imaging, medical treatment, medical prevention, and surgical intervention of nephrolithiasis. Also compensatory insulin resistance is needed to avoid hypoglycemia. Insulin resistance is a quite common state, associated with aging and a sedentary lifestyle, as well as a genetic predisposition. Diabetes mellitus pathophysiology quizlet diabetestalk. Diabetes mellitus is when blood sugar is higher than normal. Insulin resistance has also been arbitrarily defined as the requirement of 200 or more units of insulin per day to attain.
Insulin resistance is a major pathophysiology in polycystic ovary syndrome pcos, and assessment of insulin sensitivity is important. In most patients, insulin resistance can be detected long before the deterioration of glucose intolerance occurs. Pathophysiology of type 2 diabetes and its treatment policy article in japan medical association journal 531. Chronic hyperinsulinemia is a major contributor to glucose and lipid metabolism abnormalities. It may also be used in the treatment of type 2 diabetes if insulin levels remain low despite the use of other types of medications, although most people with type 2 diabetes do not require insulin in the early stages of the disease. Insulin is used in the treatment of people with type 1 diabetes who produce little or no insulin. Insulin resistance or its sequelae may be the common etiology of maladies associated with metabolic syndrome eg, hypertension, type 2 diabetes, atherosclerosis, heart. That clinicians look for the underlying causes for nephrolithiasis is imperative to direct management. Insulin resistance is a state in which a given concentration of insulin produces a lessthanexpected biological effect. Insulin infusion is typically adjusted to achieve a glucose drop of 5075 mgdl per hour. In contrast, evidence is presented supporting the view that the combination of insulin resistance and compensatory hyperinsulinemia predisposes to the development of a cluster of abnormalities, including some degree of glucose intolerance, an increase in plasma triglyceride and a decrease in highdensity lipoprotein cholesterol concentrations. In the past decade, a large number of endocrine, inflammatory, neural, and cellintrinsic pathways have been shown to be dysregulated in obesity.
Insulin secretion is and insulin resistance ir were studied in lean and obese with normal and impaired glucose metabolism igm. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that. Antiinsulin antibodies in titers sufficient to impair insulin action are rare in patients treated with recombinant human insulin, and the broad spectrum of clinical disorders in which insulin resistance plays a major role has changed markedly. Obesity, insulin resistance and metabolic syndrome.
In people with insulin resistance, the muscles, fat and liver cells fail to respond to insulin in this way and glucose remains in the blood rather than being taken up, even when insulin levels are raised. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. The development of muscle insulin resistance can lead to metabolic disease. There is currently no validated test to measure insulin resistance in clinical practice, and the diagnosis is usually made clinically. All about insulin resistance american diabetes association 1800diabetes 3422383. Insulin resistance is defined as a failure of target organs to respond normally to the action of insulin. Substantial emerging evidence suggests that these three conditions are epidemiologically and mechanistically linked. How obesity is linked to insulin resistance, and how does it develop.
Horses do not progress to be frankly diabetic as easily as other species do. Pathophysiology of insulin resistance and steatosis in. Obesityassociated insulin resistance is a major risk factor for type 2 diabetes and cardiovascular disease. Airway colonization, ventilatorassociated tracheobronchitis vat, and hospitalacquired hap and ventilatorassociated pneumonia vap are three manifestations having the presence of microorganisms in airways in common. In type 2 diabetes, the underpinning of its pathophysiology, insulin resistance, present in almost every individual with type 2 diabetes, starts early. Gerasymchuk pathophysiology department, ivanofrankivsk national medical university. Impaired insulinmediated glucose uptake is a uniformly observed characteristic of the heart in these states, although changes in upstream kinase signaling are variable and dependent on the severity and duration of the associated obesity or diabetes. Insulin resistance ir is characterized by decreasing sensitivity of target tissues to the action of insulin, elevated blood glucose concentration, and increased hepatic production of atherogenic. Behaviour of uric acid levels may thus indicate along with coexistence of lipid derangements, the ongoing pathophysiology in diabetes in relation to glycemic control, insulin resistance, onset. Decreased insulin in lean and insulin resistance in obese. Pharmacology of diabetic, antihypertensive, and antidepressant drugs living with diabetes oftentimes goes hand in hand with hypertension, and it is not uncommon for depression to result as part of living with comorbidities. A major obesityrelated burden is related to its metabolic and cardiovascular complications, with major roles for insulin resistance, type 2 diabetes and cardiovascular disease. Pathophysiology, concepts of altered health states, carol mattson porth, glenn matfin. Understanding insulin resistance pathophysiology in pcos.
Mellitus is comprised by a range of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion and excessive or inappropriate glucagon secretion. Insulin resistance is a condition in which there is decreased ability of insulin to stimulate glucose disposal by muscle, adipose tissue, and liver. Obesity, metabolic syndrome, and asthma are all rapidly increasing globally. Insulin resistance in skeletal muscle manifests itself primarily as a reduction in insulinstimulated. The study establishes that in indian women, variations in genes related to insulin resistance do have an influence on the pathophysiology of pcos. Insulin is secreted at a low, basal level in the nonfed state, with increased, stimulated levels at mealtimes. Since the link between obesity and asthma appears to extend beyond mechanical pulmonary disadvantage, molecular understanding is necessary. Huether, msn, phd professor emeritus college of nursing university of utah salt lake city, utah kathryn l. Pathophysiology and pharmacological treatment of insulin. Request pdf pathophysiology of type 2 diabetes and its treatment policy impaired. Stand on a streetcorner and ask people if they know what insulin is, and many will reply, doesnt it have something to do with blood sugar. Relation of insulin resistance with genetic and environmental factors has. Insulin resistance is a characteristic feature of obesity and type 2 diabetes and impacts the heart in various ways.