insulin resistance
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Etiology
- endocrine disorders associated with insulin resistance
- obesity
- fast food restaraunt food See CARDIA study
Pathology
- elevated levels of circulating insulin
- fasting
- post-prandial
- hypertension
- obesity
- high triglycerides
- low HDL cholesterol
- small LDL particle size
- carbohydrate intolerance
- diabetes mellitus
- reactive oxygen species implicated[4]
- plasma retinol-binding protein 4 may be a cause of insulin-resistance NOT simply a marker
- muscle weakness, decreased quadriceps strength[8]
Genetics
- associated with defects in insulin receptor
Laboratory
- plasma retinol-binding protein 4 levels correlate with insulin resistance[4]
- MT-RNR1 gene mutation
- also see ARUP consult[10]
Radiology
- 18F-fluorodeoxyglucose-PET scan neuroimaging (investigational)
- lower regional cerebral metabolic rates for glucose in the precuneus, posterior cingulate gyrus, parietal lobe, prefrontal lobe, & occipital lobe[9]
Complications
- higher fasting glucose & glycosylated hemoglobin levels, even within the normal range, are associated with cognitive impairment & hippocampal abnormalities[9]
Management
- diet & exercise[5][6][7]
- calorie restriction results in loss of muscle mass in obese elderly thus is less preferable to exercise alone for management of insulin resistance[7]
- outcomes not considered
- low-energy dense diet reduces insulin resistance
- potato & bean diets low in energy density are equally effective in reducing insulin resistance & promoting weight loss in subjects with impaired glycemic control[11]
- calorie restriction results in loss of muscle mass in obese elderly thus is less preferable to exercise alone for management of insulin resistance[7]
More general terms
Additional terms
- diabetes mellitus type 2 (insulin-resistant)
- endocrine disorders associated with insulin resistance
- impaired glucose tolerance
References
- ↑ Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 505
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 18. American College of Physicians, Philadelphia 1998, 2012, 2018.
- ↑ Houstis N et al, Reactive oxygen species have a causal role in multiple forms of insulin resistance. Nature 2006; 440:944 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16612386
- ↑ 4.0 4.1 4.2 Graham TE et al, Retinol-binding protein 4 and insulin resistance in lean, obese and diabetic subjects. N Engl J Med 2006; 354:2552 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16775236
- ↑ 5.0 5.1 Davidson LE, Hudson R, Kilpatrick K et al Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial. Arch Intern Med. 2009 Jan 26;169(2):122-31. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19171808
- ↑ 6.0 6.1 Yassine HN, Marchetti CM, Krishnan RK et al Effects of exercise and caloric restriction on insulin resistance and cardiometabolic risk factors in older obese adults--a randomized clinical trial. J Gerontol A Biol Sci Med Sci. 2009 Jan;64(1):90-5 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19164269
- ↑ 7.0 7.1 7.2 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
- ↑ 8.0 8.1 Barzilay JI, Cotsonis GA, Walston J Insulin resistance is associated with decreased quadriceps muscle strength in nondiabetic adults aged >or=70 years. Diabetes Care. 2009 Apr;32(4):736-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19171728
- ↑ 9.0 9.1 9.2 Ryu SY et al. Effects of insulin resistance on white matter microstructure in middle-aged and older adults. Neurology 2014 Apr 25 http://www.neurology.org/content/82/21/1862
- ↑ 10.0 10.1 ARUP consult: Inherited Insulin Resistance Syndromes (INSR) Genetic Testing https://arupconsult.com/ati/inherited-insulin-resistance-syndromes
- ↑ 11.0 11.1 Splete H Both Potatoes and Beans Reduced Insulin Resistance, Weight in Controlled Study. Medscape. Dec 1, 2022 https://www.medscape.com/viewarticle/984876
Rebello CJ, Beyl RA, Greenway FL et al Low-Energy Dense Potato- and Bean-Based Diets Reduce Body Weight and Insulin Resistance: A Randomized, Feeding, Equivalence Trial. J Med Food. 2022 Nov 11. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36367708 - ↑ Insulin Resistance and Pre-Diabetes http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/index.htm
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