The good, the bad, and the ugly facets of insulin resistance - PubMed (original) (raw)

Review

The good, the bad, and the ugly facets of insulin resistance

K V S Hari Kumar. Med J Armed Forces India. 2020 Jan.

Abstract

Insulin is a potent anabolic hormone, and binding to its receptor activates downstream intracellular signaling pathways that regulate the nutrient metabolism, fluid homeostasis, growth, ionic transport, maintenance of vascular tone, and other functions. Insulin resistance (IR) is a condition characterized by subnormal cellular response to physiological levels of insulin. The IR is divided into three types (prereceptor, receptor, and postreceptor) based on the site of pathology. Beta cells attempt to overcome the IR by increasing the release of insulin, leading to hyperinsulinemia. IR is the predisposing factor for many metabolic and cardiovascular disorders. From the evolutionary perspective, the presence of IR offers a survival advantage in the face of starvation or stress. In this brief review, we discuss the different facets of insulin resistance and appraise the readers about the hitherto neglected beneficial advantages.

Keywords: Diabetes; Insulin resistance; Lifestyle disease; Non-alcoholic fatty liver disease; Polycystic ovarian disease.

© 2019 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.

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Figures

Fig. 1

Fig. 1

Spectrum of insulin resistance. PCOD, polycystic ovarian disease; T2DM, type 2 diabetes mellitus; BPH, benign prostatic hyperplasia; NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis.

Fig. 2

Fig. 2

Facets of insulin resistance. PCOD, polycystic ovarian disease; BPH, benign prostatic hyperplasia; NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis.

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