Treatment of insulin resistance in diabetes mellitus.
Insulin resistance is a condition in which the glycemic response to insulin is less than normal. The change in insulin sensitivity leads to several sets of responses. One set effects the beta cell and leads to its accelerated destruction and the development of diabetes mellitus. The other set generates a series of nontraditional cardiovascular risk factors that result in accelerated atherosclerosis. Both of these sets of responses may have impacts on other tissues such as the nervous system. Insulin resistance is probably the result of increased visceral adiposity with increased release of free fatty acids and cytokines and a decreased release of adiponectin. Treatment of insulin resistance and its associated abnormalities can be achieved by lifestyle modification which results in weight loss, by drugs that reverse the abnormal adipocyte effects, by drugs that improve insulin sensitivity at the level of the liver and by anti-inflammatory agents that block activation of the nuclear factor kappa B cascade.
Lebovitz
Harold E
HE
Department of Medicine, State University of New York Health Science Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA. hlebovitz@attglobal.net
Banerji
Mary Ann
MA
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001835:Body Weight / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D006949:Hyperlipidemias / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D045162:Thiazolidinediones / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D008687:Metformin