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Insulin Resistance Syndrome and Hyperinsulinemia
The term "insulin resistance" describes a condition of the reduced sensitivity of a cell to the action of insulin. Insulin must bind "effectively" to the cell receptor as one of the first steps in appropriate glucose metabolism. If insulin is less than effective at the receptor, glucose levels tend to rise signaling a "need" for more insulin. The body responds by secreting excessive insulin, at times reaching 4-5 times the expected physiologic level. This secondary hyperinsulinemia can have a deleterious effect on the pancreas as it tries in vain to keep up with this excessive demand. The pancreas begins to fail and sets the stage for type 2 diabetes. Eager physicians are quick to prescribe a first- or second-generation diabetic medication, betting on the pancreas to produce even more insulin and further hastening the demise of the pancreas beta cells. This insulin resistance or insensitivity leads to glucose intolerance and dysglycemia. Insulin Resistance Syndrome (IRS) also referred to as Syndrome X or Metabolic Syndrome refers to a set of metabolic abnormalities. IRS is associated with glucose intolerance, abnormally low HDL (high density lipoprotein) cholesterol and/or high triglyceride levels, high blood pressure and upper body obesity. All of these factors are independent risk factors for coronary heart disease (CHD). CHD develops from a direct effect of insulin that stimulates lipogenesis in arterial tissue and enhances the growth of arterial smooth muscle promoting atherosclerosis. Increased insulin levels decrease fibrinolysis, increasing the risk for coronary thrombosis. Insulin also increases the hepatic production of triglycerides and lowers production of HDL (good cholesterol). High blood pressure may also be caused from the elevated insulin's effect on renal sodium reabsorption. Weight loss is a major benefit to those with Insulin Resistance Syndrome. High dose vitamin E has been reported to improve insulin resistance in type 2 diabetic patients. Zinc, selenium and vitamin C have been associated with decreasing oxidative stress in diabetic patients. |