Skip to main content

Pathophysiology of Insulin Resistance: Implications for Prevention

  • Chapter
  • First Online:
Prevention of Type 2 Diabetes

Abstract

Insulin resistance is a condition in which there is decreased ability of insulin to stimulate glucose disposal by muscle, adipose tissue, and liver. Insulin resistance (IR) is characterized by decreasing sensitivity of target tissues to the action of insulin, elevated blood glucose concentration, and increased hepatic production of atherogenic lipids. IR is associated with declining insulin production by the pancreas, the emergence of T2DM, and increasing risk of cardiovascular disease (CVD).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Targher G, et al. Prevalence of insulin resistance in metabolic disorders: the Bruneck study. Diabetes. 1998;47(10):1643–9.

    Article  PubMed  CAS  Google Scholar 

  2. Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care. 2006;29(5):1130–9.

    Article  PubMed  CAS  Google Scholar 

  3. Le Roith D, Zick Y. Recent advances in our understanding of insulin action and insulin resistance. Diabetes Care. 2001;24(3):588–97.

    Article  PubMed  Google Scholar 

  4. Thies RS, Molina JM, Ciaraldi TP, Freidenberg GR, Olefsky JM. Insulin-receptor autophosphorylation and endogenous substrate phosphorylation in human adipocytes from control, obese, and NIDDM subjects. Diabetes. 1990;39(2):250–9.

    Article  PubMed  CAS  Google Scholar 

  5. Roach P, Zick Y, Formisano P, Accili D, Taylor SI, Gorden P. A novel human insulin receptor gene mutation uniquely inhibits insulin binding without impairing posttranslational processing. Diabetes. 1994;43(9):1096–102.

    Article  PubMed  CAS  Google Scholar 

  6. Grigorescu F, Flier JS, Kahn CR. Characterization of binding and phosphorylation defects of erythrocyte insulin receptors in the type A syndrome of insulin resistance. Diabetes. 1986;35(2):127–38.

    Article  PubMed  CAS  Google Scholar 

  7. Kruszynska YT, Olefsky JM. Cellular and molecular mechanisms of non-insulin dependent diabetes mellitus. J Investig Med. 1996;44(8):413–28.

    PubMed  CAS  Google Scholar 

  8. Kelley DE, Mintun MA, Watkins SC, Simoneau JA, Jadali F, Fredrickson A, et al. The effect of non-insulin-dependent diabetes mellitus and obesity on glucose transport and phosphorylation in skeletal muscle. J Clin Invest. 1996;97(12):2705–13.

    Article  PubMed  CAS  Google Scholar 

  9. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–9.

    Article  PubMed  CAS  Google Scholar 

  10. Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85(7):2402–10.

    Article  PubMed  CAS  Google Scholar 

  11. Kolterman OG, Gray RS, Griffin J, Burstein P, Insel J. Receptor and postreceptor defects contribute to the insulin resistance in noninsulin-dependent diabetes mellitus. J Clin Invest. 1981;68(4):957–69.

    Article  PubMed  CAS  Google Scholar 

  12. Ferrannini E, Mari A. How to measure insulin sensitivity. J Hypertens. 1998;16(7):895–906.

    Article  PubMed  CAS  Google Scholar 

  13. Cline GW, Petersen KF, Krssak M, Shen J, Hundal RS, Trajanoski Z, et al. Impaired glucose transport as a cause of decreased insulin-stimulated muscle glycogen synthesis in type 2 diabetes. N Engl J Med. 1999;341(4):240–6.

    Article  PubMed  CAS  Google Scholar 

  14. Kruszynska YT, Mulford MI, Baloga J, Yu JG, Olefsky JM. Regulation of skeletal muscle hexokinase II by insulin in nondiabetic and NIDDM subjects. Diabetes. 1998;47(7):1107–13.

    Article  PubMed  CAS  Google Scholar 

  15. Thorburn AW, Gumbiner B, Bulacan F, Brechtel G, Henry RR. Multiple defects in muscle glycogen synthase activity contribute to reduced glycogen synthesis in non-insulin dependent diabetes mellitus. J Clin Invest. 1991;87(2):489–95.

    Article  PubMed  CAS  Google Scholar 

  16. Petersen JL, McGuire DK. Impaired glucose tolerance and impaired fasting glucose—a review of diagnosis, clinical implications and management. Diab Vasc Dis Res. 2005;2(1):9–15.

    Article  PubMed  Google Scholar 

  17. Grundy SM. Hypertriglyceridemia, insulin resistance, and the metabolic syndrome. Am J Cardiol. 1999;83(9B):25F–9.

    Article  PubMed  CAS  Google Scholar 

  18. Rundek T, Gardener H, Xu Q, Goldberg RB, Wright CB, Boden-Albala B, et al. Insulin resistance and risk of ischemic stroke among nondiabetic individuals from the northern Manhattan study. Arch Neurol. 2010;67(10):1195–200.

    Article  PubMed  Google Scholar 

  19. Manco M, Panunzi S, Macfarlane DP, Golay A, Melander O, Konrad T, et al. One-hour plasma glucose identifies insulin resistance and beta-cell dysfunction in individuals with normal glucose tolerance: cross-sectional data from the Relationship between Insulin Sensitivity and Cardiovascular Risk (RISC) study. Diabetes Care. 2010;33(9):2090–7.

    Article  PubMed  CAS  Google Scholar 

  20. Mamas MA, Deaton C, Rutter MK, Yuille M, Williams SG, Ray SG, et al. Impaired glucose tolerance and insulin resistance in heart failure: underrecognized and undertreated? J Card Fail. 2010;16(9):761–8.

    Article  PubMed  CAS  Google Scholar 

  21. Dinh W, Lankisch M, Nickl W, Scheyer D, Scheffold T, Kramer F, et al. Insulin resistance and glycemic abnormalities are associated with deterioration of left ventricular diastolic function: a cross-sectional study. Cardiovasc Diabetol. 2010;9:63.

    Article  PubMed  Google Scholar 

  22. Abrahamson MJ. A 74-year-old woman with diabetes. JAMA. 2007;297(2):196–204.

    Article  PubMed  CAS  Google Scholar 

  23. Sierra-Johnson J, Johnson BD, Allison TG, Bailey KR, Schwartz GL, Turner ST. Correspondence between the adult treatment panel III criteria for metabolic syndrome and insulin resistance. Diabetes Care. 2006;29(3):668–72.

    Article  PubMed  Google Scholar 

  24. Groop LC, Barzilai N, Ratheiser K, Luzi L, Wahlin-Boll E, Melander A, et al. Dose-dependent effects of glyburide on insulin secretion and glucose uptake in humans. Diabetes Care. 1991;14(8):724–7.

    Article  PubMed  CAS  Google Scholar 

  25. Belfort R, Mandarino L, Kashyap S, Wirfel K, Pratipanawatr T, Berria R, et al. Dose-response effect of elevated plasma free fatty acid on insulin signaling. Diabetes. 2005;54(6):1640–8.

    Article  PubMed  CAS  Google Scholar 

  26. Unger RH. Lipotoxicity in the pathogenesis of obesity-dependent NIDDM. Genetic and clinical implications. Diabetes. 1995;44(8):863–70.

    Article  PubMed  CAS  Google Scholar 

  27. Ebbesson SO, Tejero ME, Lopez-Alvarenga JC, Harris WS, Ebbesson LO, Devereux RB, et al. Individual saturated fatty acids are associated with different components of insulin resistance and glucose metabolism: the GOCADAN study. Int J Circumpolar Health. 2010;69(4):344–51.

    PubMed  Google Scholar 

  28. Perseghin G, Scifo P, De Cobelli F, Pagliato E, Battezzati A, Arcelloni C, et al. Intramyocellular triglyceride content is a determinant of in vivo insulin resistance in humans: a 1H-13C nuclear magnetic resonance spectroscopy assessment in offspring of type 2 diabetic parents. Diabetes. 1999;48(8):1600–6.

    Article  PubMed  CAS  Google Scholar 

  29. Phillips DI, Caddy S, Ilic V, Fielding BA, Frayn KN, Borthwick AC, et al. Intramuscular triglyceride and muscle insulin sensitivity: evidence for a relationship in nondiabetic subjects. Metabolism. 1996;45(8):947–50.

    Article  PubMed  CAS  Google Scholar 

  30. Pan DA, Lillioja S, Kriketos AD, Milner MR, Baur LA, Bogardus C, et al. Skeletal muscle triglyceride levels are inversely related to insulin action. Diabetes. 1997;46(6):983–8.

    Article  PubMed  CAS  Google Scholar 

  31. Kasa-Vubu JZ, Lee CC, Rosenthal A, Singer K, Halter JB. Cardiovascular fitness and exercise as determinants of insulin resistance in postpubertal adolescent females. J Clin Endocrinol Metab. 2005;90(2):849–54.

    Article  PubMed  CAS  Google Scholar 

  32. Slentz CA, Tanner CJ, Bateman LA, Durheim MT, Huffman KM, Houmard JA, et al. Effects of exercise training intensity on pancreatic beta-cell function. Diabetes Care. 2009;32(10):1807–11.

    Article  PubMed  CAS  Google Scholar 

  33. Davidson LE, Hudson R, Kilpatrick K, Kuk JL, McMillan K, Janiszewski PM, et al. Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial. Arch Intern Med. 2009;169(2):122–31.

    Article  PubMed  Google Scholar 

  34. Jones LM, Meredith-Jones K, Legge M. The effect of water-based exercise on glucose and insulin response in overweight women: a pilot study. J Womens Health (Larchmt). 2009;18(10):1653–9.

    Article  Google Scholar 

  35. Inzucchi SE, Maggs DG, Spollett GR, Page SL, Rife FS, Walton V, et al. Efficacy and metabolic effects of metformin and troglitazone in type II diabetes mellitus. N Engl J Med. 1998;338(13):867–72.

    Article  PubMed  CAS  Google Scholar 

  36. Yokota T, Kinugawa S, Hirabayashi K, Suga T, Takada S, Takahashi M, et al. Pioglitazone increases the aerobic capacity with improved skeletal muscle energetics in patients with insulin resistance. Diabetologia. 2010;53:S276.

    Google Scholar 

  37. Lebovitz HE, Banerji MA. Insulin resistance and its treatment by thiazolidinediones. Recent Prog Horm Res. 2001;56:265–94.

    Article  PubMed  CAS  Google Scholar 

  38. Dormandy JA, Charbonnel B, Eckland DJ, Erdmann E, Massi-Benedetti M, Moules IK, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive study (PROspective pioglitAzone clinical trial in macroVascular events): a randomised controlled trial. Lancet. 2005;366(9493):1279–89.

    Article  PubMed  CAS  Google Scholar 

  39. BARI 2D Study Group, Frye RL, August P, Brooks MM, Hardison RM, Kelsey SF, et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009;360(24):2503–15.

    Article  PubMed  CAS  Google Scholar 

  40. Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE, et al. Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab. 2001;86(5):1930–5.

    Article  PubMed  CAS  Google Scholar 

  41. Saha AK, Schwarsin AJ, Roduit R, Masse F, Kaushik V, Tornheim K, et al. Activation of malonyl-CoA decarboxylase in rat skeletal muscle by contraction and the AMP-activated protein kinase activator 5-aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside. J Biol Chem. 2000;275(32):24279–83.

    Article  PubMed  CAS  Google Scholar 

  42. Chandran M, Phillips SA, Ciaraldi T, Henry RR. Adiponectin: more than just another fat cell hormone? Diabetes Care. 2003;26(8):2442–50.

    Article  PubMed  CAS  Google Scholar 

  43. Petersen KF, Oral EA, Dufour S, Befroy D, Ariyan C, Yu C, et al. Leptin reverses insulin resistance and hepatic steatosis in patients with severe lipodystrophy. J Clin Invest. 2002;109(10):1345–50.

    PubMed  CAS  Google Scholar 

  44. Gumbs AA, Modlin IM, Ballantyne GH. Changes in insulin resistance following bariatric surgery: role of caloric restriction and weight loss. Obes Surg. 2005;15(4):462–73.

    Article  PubMed  Google Scholar 

  45. de Moura EG, Orso IR, Martins BD, Lopes GS, de Oliveira SL, Galvao-Neto MD, et al. Improvement of insulin resistance and reduction of cardiovascular risk among obese patients with type 2 diabetes with the duodenojejunal bypass liner. Obes Surg. 2011;21(7):941–7.

    Article  PubMed  Google Scholar 

  46. Goldfine AB, Silver R, Aldhahi W, Cai D, Tatro E, Lee J, et al. Use of salsalate to target inflammation in the treatment of insulin resistance and type 2 diabetes. Clin Transl Sci. 2008;1(1):36–43.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vivian A. Fonseca MD, FRCP .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media New York

About this chapter

Cite this chapter

Ali, S., Fonseca, V.A. (2012). Pathophysiology of Insulin Resistance: Implications for Prevention. In: LeRoith, D. (eds) Prevention of Type 2 Diabetes. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3314-9_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-3314-9_3

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-3313-2

  • Online ISBN: 978-1-4614-3314-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics