Insulin resistance: site of the primary defect or how the current and the emerging therapies work.
Insulin resistance is one of the cardinal pathophysiological components of the metabolic syndrome, type 2 diabetes, and frequently co-exists with essential hypertension. Although insulin resistance is defined as inadequate target organ (muscle, liver and fat) responsiveness and/or sensitivity to insulin, the primary defect may be located in the target organs themselves or at their remote controller--the central nervous system. One of the ways of resolving this dilemma is studying the mechanisms of action of drugs that have insulin-sensitizing properties. In this brief review we discuss how the known and potential insulin sensitizers: metformin, appetite suppressants, thiazolidinediones, and the new class of centrally acting antihypertensive drugs, I1-receptor agonists, may work.
Kolaczynski
J W
JW
Eli Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA.
Caro
J F
JF
D000273:Adipose Tissue / Q000187:drug effects; D001067:Appetite Depressants / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005277:Fenfluramine / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007093:Imidazoles / Q000819:agonists; D007333:Insulin Resistance / Q000502:physiology*; D008024:Ligands; D008687:Metformin / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use; D045162:Thiazolidinediones
D001067:Appetite Depressants; D007004:Hypoglycemic Agents; D007093:Imidazoles; D008024:Ligands; D013844:Thiazoles; D045162:Thiazolidinediones; D005277:Fenfluramine; D008687:Metformin; C089946:2,4-thiazolidinedione