| Theme | Forefront of Diabetic Nephropathy | |
|---|---|---|
| Title | The treatments of insulin resistance | |
| Publish Date | 2001/01 | |
| Author | Motoaki Shichiri | Department of Metabolic Medicine, Kumamoto University School of Medicine |
| Author | Hiroyuki Motoshima | Department of Metabolic Medicine, Kumamoto University School of Medicine |
| Author | Eiichi Araki | Department of Metabolic Medicine, Kumamoto University School of Medicine |
| [ Summary ] | Insulin actions in insulin-sensitive tissues are impaired in insulin resistant states. Although the molecular mechanisms of insulin resistance are not fully understood, some genetic and environmental factors, as well as glucose toxicity, contribute to the development of insulin resistance. Obesity with visceral fat accumulation is one of the major factors inducing insulin resistance. Several factors released from adipocytes, such as TNF alpha and FFA, may cause insulin resistance in skeletal muscles, adipose tissues and liver. The hyperinsulinemic-euglycemic clamp test is the most reliable method to assess the insulin resistance in vivo, but other alternative methods, such as the HOMA-IR, oral glucose tolerance test and insulin tolerance test, are also available. Diet and exercise therapies should be the first choice of treatment for insulin resistance, but when these therapies are not effective, thiazolidinediones and/or metformin may be selected. |
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