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Insulin Resistance Reduction
Receptor sensitivity for insulin decreases and the body compensates by secreting increased amounts of insulin. This is known as "insulin resistance". Increased insulin levels promote lipogenesis, increased thrombosis from increase in plaminogen activator/inhibitor, and decreases through a hepatic mechanism, which will decrease HDL while increasing triglyceride production. One of the most devastating effects is the glycosylation process, whereby circulating glucose attaches to proteins. Eventually this leads to advanced glycosylation end products (AGE), which can be a precursor to microvascular disease. The abnormal glucose/insulin metabolism augments formation of free radicals. Of course, oxidative stress is often responsible for many of the factors contributing to coronary artery disease. Other than the substances noted in Table 5, caloric restriction is an excellent way to decrease free radical formation and improve insulin sensitivity. Equally as important is a regular exercise program given that insulin receptors are located within muscle tissue. In addition, repletion with antioxidants is also imperative (see Table 6).
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