Insulin Resistance (cont.)
What is the relationship between insulin resistance and diabetes?
Type 2 diabetes is the type of diabetes that occurs later in life.
Insulin resistance precedes the development of type 2 diabetes, sometimes by years. In individuals
who will ultimately develop type 2 diabetes, it is believed that blood glucose
and insulin levels are normal for many years; then at some point in time,
insulin resistance
develops.
At this point, there is often an association of high
insulin levels, central obesity, cholesterol abnormalities, and /or high blood pressure (hypertension). When this
constellation of disease processes occur, it is know as the
metabolic
syndrome.
One of the actions of insulin is to cause the cells of
the body, particularly the muscle and fat cells, to remove and use glucose from
the blood. This is one way in which insulin controls the level of glucose in
blood. Insulin has this effect on the cells by binding to insulin receptors on
the surface of the cells. You can think of it as insulin "knocking" on the doors
of muscle and fat cells. The cells hear the knock, open up, and let glucose in
to be used by the cell. With insulin resistance, the muscles don't hear the knock as well (they
are resistant), and the pancreas is notified that it needs to make more insulin,
which increases the level of insulin in the blood and causes a louder knock.
The
resistance of the cells continues to increase over time. As long as the pancreas
is able to produce enough insulin to overcome this resistance, blood glucose
levels remain normal. When the pancreas can no longer produce enough insulin,
the blood glucose levels begin to rise, initially after meals when glucose
levels are at their highest and more insulin is needed, but eventually in the
fasting state too. At this point, type 2 diabetes is present.
Next: What medical conditions are associated with insulin resistance? »
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