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Is Type 1 Diabetes Associated With Insulin Resistance?

Insulin Resistance

Insulin Resistance

What medical conditions are associated with insulin resistance? While the metabolic syndrome links insulin resistance with abdominal obesity, elevated cholesterol, and high blood pressure; several other medical other conditions are specifically associated with insulin resistance. Insulin resistance may contribute to the following conditions: Type 2 Diabetes: Overt diabetes may be the first sign insulin resistance is present. Insulin resistance can be noted long before type 2 diabetes develops. Individuals reluctant or unable to see a health-care professional often seek medical attention when they have already developed type 2 diabetes and insulin resistance. Fatty liver: Fatty liver is strongly associated with insulin resistance. Accumulation of fat in the liver is a manifestation of the disordered control of lipids that occurs with insulin resistance. Fatty liver associated with insulin resistance may be mild or severe. Newer evidence suggests fatty liver may even lead to cirrhosis of the liver and, possibly, liver cancer. Arteriosclerosis: Arteriosclerosis (also known as atherosclerosis) is a process of progressive thickening and hardening of the walls of medium-sized and large arteries. Arteriosclerosis is responsible for: Other risk factors for arteriosclerosis include: High levels of "bad" (LDL) cholesterol Diabetes mellitus from any cause Family history of arteriosclerosis Skin Lesions: Skin lesions include increased skin tags and a condition called acanthosis nigerians (AN). Acanthosis nigricans is a darkening and thickening of the skin, especially in folds such as the neck, under the arms, and in the groin. This condition is directly related to the insulin resistance, though the exact mechanism is not clear. Acanthosis nigricans is a cosmetic condition strongly Continue reading >>

Insulin Resistance

Insulin Resistance

Insulin resistance is a measurement of the body's cells and tissues to use insulin. If a person is insulin resistant, that is, has a higher level of insulin resistance, then their body does not respond as well to insulin as someone who is insulin sensitive. Does Insulin Resistance Contribute to Type 1 Diabetes? In a group of close relatives of people with type 1 diabetes who also tested positive for autoantibodies, The European Nicotinamide Diabetes Intervention Trial (ENDIT), found that insulin resistance accelerates progression to type 1 diabetes in those who do not produce much insulin, but does not affect progression in people who still produce relatively higher amounts of insulin (Bingley et al. 2008). Another study of antibody-positive relatives, this time in North America, found clear evidence of an association between insulin resistance and progression to type 1 diabetes (Xu et al. 2007). A Finnish study of siblings of children with type 1 diabetes found that increased insulin resistance was associated with the development of type 1 diabetes in those who were antibody-positive (Mrena et al. 2006). An Australian study found that antibody-positive relatives who progress more quickly to type 1 diabetes have greater insulin resistance for their level of insulin secretion (Fourlanos et al. 2004). In Finnish children who were at genetic risk and already antibody positive, insulin resistance was slightly higher in those who went on to develop type 1 diabetes, although its role was minor compared to other factors (such as autoantibody levels, younger age, and reduced insulin secretion) (Siljander et al. 2013). The TrialNet study (of family members of people with type 1 diabetes) found no increased risk of multiple type 1-related autoantibodies or type 1 diabetes with hi Continue reading >>

The Interplay Of Autoimmunity And Insulin Resistance In Type 1 Diabetes

The Interplay Of Autoimmunity And Insulin Resistance In Type 1 Diabetes

Specialty: Pediatrics, Endocrinology, Immunology Institution: Section of Endocrinology, Department of Pediatrics, University of Colorado Denver and Children's Hospital Colorado Address: Aurora, Colorado, 80045, United States Author: Marian Rewers Specialty: Endocrinology, Pediatrics, Immunology Institution: Department of Pediatrics, University of Colorado School of Medicine Address: Aurora, Colorado, 80045, United States Institution: Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine Address: Aurora, Colorado, 80045, United States Author: Melanie Cree Green Specialty: Endocrinology, Pediatrics, Immunology Institution: Department of Pediatrics, University of Colorado School of Medicine Address: Aurora, Colorado, 80045, United States Institution: Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine Address: Aurora, Colorado, 80045, United States Abstract: Type 1 diabetes (T1D) is a common chronic disease characterized by selective autoimmune destruction of the pancreatic islet beta cells and subsequent dependence on exogenous insulin. Certain alleles including the high-risk HLA genotype, HLA-DR3-DQ2/DR4-DQ8, place individuals at increased risk of developing T1D. Autoantibodies to beta cell antigens are used in the diagnosis of T1D, and studies have shown that they can be used to predict risk of developing T1D in first degree relatives of probands. The annual global incidence of T1D is increasing by 3-5% per year. Many environmental factors have been implicated in the rising incidence of T1D. Proponents of the accelerator hypothesis argue that T1D and type 2 diabetes (T2D) are the same disorder of insulin resistance, although with different genetic backgrounds. While insulin resistance is a recognized ha Continue reading >>

Double Diabetes

Double Diabetes

Tweet Double diabetes is when someone with type 1 diabetes develops insulin resistance, the key feature of type 2 diabetes. Someone with double diabetes will always have type 1 diabetes present but the effects of insulin resistance can be reduced somewhat. The most common reason for developing insulin resistance is obesity and whilst type 1 diabetes is not itself brought on by obesity. People with type 1 diabetes are able to become obese and suffer from insulin resistance as much as anyone else. What is the difference between type 1 and type 2 diabetes? Type 1 diabetes is an autoimmune disease whereby the body’s immune system attacks and kills off its own insulin producing cells. The autoimmune effect is not prompted by being overweight. Over a period of time, the vast majority, if not all, of insulin producing cells are destroyed. Without being able to produce insulin, blood sugar levels rise and the symptoms of diabetes appear. Type 2 diabetes is closely related to obesity, 85% of cases of type 2 diabetes occur in people who are obese. Although the process is not yet fully understood, it is largely believed that obesity causes the body’s cells to become resistant to insulin. As a result, people with either type 2 diabetes or pre-diabetes start to produce more insulin than those without the condition and one of the consequences of this is further weight gain which helps to reinforce the condition. Type 2 diabetes develops gradually, usually over a period of years before symptoms, such as frequent urination, become noticeable. Progression of double diabetes Similar to type 2 diabetes, double diabetes, if not treated appropriately can become more severe over time. If double diabetes is allowed to progress more insulin will need to be injected which promotes further w Continue reading >>

Insulin Resistance, Type 1 And Type 2 Diabetes, And Related Complications: Current Status And Future Perspective

Insulin Resistance, Type 1 And Type 2 Diabetes, And Related Complications: Current Status And Future Perspective

Insulin Resistance, Type 1 and Type 2 Diabetes, and Related Complications: Current Status and Future Perspective Joseph Fomusi Ndisang ,1 Sharad Rastogi ,2and Alfredo Vannacci 3 1Department of Physiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, Canada S7N 5E5 2Division of Cardiology, Department of Medicine, Henry Ford Heart and Vascular Institute, 2799 West Grand Boulevard, Detroit, MI 48202-2689, USA 3Department of Pharmacology, Center for Integrative Medicine, Center for Molecular Medicine (CIMMBA), University of Florence, Viale Pieraccini 6, 50139 Florence, Italy Received 12 February 2014; Accepted 12 February 2014; Published 18 March 2014 Copyright 2014 Joseph Fomusi Ndisang et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The global escalation of obesity and diabetes in developed and developing nations poses a great health challenge. Obesity is one of the major causes of type 2 diabetes [ 1 , 2 ]. Type 1 diabetes is primarily due to the autoimmune-mediated destruction of pancreatic beta-cell leading to insulin deficiency [ 3 , 4 ]. This is usually accompanied by alterations in lipid metabolism, enhanced hyperglycemia-mediated oxidative stress, endothelial cell dysfunction, and apoptosis [ 3 , 4 ]. Similarly, in type 2 diabetes, increased glucotoxicity, lipotoxicity, endoplasmic reticulum-induced stress, and apoptosis lead to the progressive loss of beta-cells [ 3 , 4 ]. While type 1 diabetes is characterized by the presence of beta-cell autoantibodies, a combination of peripheral insulin resistance and dysfunctional insulin secretion by pancreatic beta Continue reading >>

Insulin Resistance Among Adults With Type 1 Diabetes Mellitus At The Philippine General Hospital

Insulin Resistance Among Adults With Type 1 Diabetes Mellitus At The Philippine General Hospital

Jerome R Barrera1*, Cecilia A Jimeno2 and Elizabeth Paz-Pacheco2 1Department of Internal Medicine, Zamboanga City Medical Center, Philippines 2Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of the Philippines-Philippine General Hospital, Philippines Citation: Barrera JR, Jimeno CA, Paz-Pacheco E (2013) Insulin Resistance among Adults with Type 1 Diabetes Mellitus at the Philippine General Hospital. J Diabetes Metab 4:315. doi:10.4172/2155-6156.1000315 Copyright: © 2013 Barrera JR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Background: Insulin resistance has been proven to increase the risks for cardiovascular complications in type 2 diabetes mellitus. Recently, insulin resistance has also been shown to play a bigger role in the natural history of type 1 diabetes mellitus (T1DM) disease process than is commonly recognized. Limitations and difficulties in assessing insulin resistance in patients with T1DM have been addressed by the creation of clinical scoring known as estimated glucose disposal rate (eGDR). Given the clear association of insulin resistance and cardiovascular complications in diabetic patients, detecting the prevalence of insulin resistance in T1DM population, will probably clarify the welldocumented gaps in the management of this type of diabetes. Objectives: The main objective of this study is to determine the prevalence of insulin resistance among Filipino adults with established type 1 diabetes mellitus at the Philippine General Hospital. T Continue reading >>

Insulin Sensitivity In T1 Prediction

Insulin Sensitivity In T1 Prediction

Insulin secretion and insulin sensitivity jointly determine circulating glucose levels. A mis-match in this relationship results in hyperglycaemia. Whilst considerable effort has been invested into studying the loss of insulin secretion in the development of type 1 diabetes, relatively little attention has been paid to insulin sensitivity. A number of studies have recently demonstrated that insulin sensitivity is associated with protection from type 1 diabetes. Measures of insulin sensitivity may usefully contribute to current algorithms for the prediction of type 1 diabetes. Furthermore, if the relationship between insulin sensitivity and the development plays a causative role, therapies that increase insulin sensitivity may delay the onset of type 1 diabetes. Continue reading >>

What Is Type 2 Diabetes?

What Is Type 2 Diabetes?

Type 2 diabetes is the most common form of diabetes. You have Type 2 diabetes if your tissues are resistant to insulin, and if you lack enough insulin to overcome this resistance. You have Type 2 diabetes if your tissues are resistant to insulin, and if you lack enough insulin to overcome this resistance. Type 2 diabetes is the most common form of diabetes of diabetes worldwide and accounts for 90-95% of cases. Risk Factors Your risk of type 2 diabetes typically increases when you are: Other risk factors are: Family history of diabetes in close relatives Being of African, Asian, Native American, Latino, or Pacific Islander ancestry High blood pressure High blood levels of fats, known as triglycerides, coupled with low levels of high-density lipoprotein, known as HDL, in the blood stream Prior diagnosis of pre-diabetes such as glucose intolerance or elevated blood sugar In women, a history of giving birth to large babies (over 9 lbs) and/or diabetes during pregnancy Type 2 diabetes is strongly inherited These are some of the statistics: 80-90% of people with Type 2 diabetes have other family members with diabetes. 10-15% of children of a diabetic parent will develop diabetes. If one identical twin has type 2 diabetes, there is up to a 75% chance that the other will also be diabetic. There are many genetic or molecular causes of type 2 diabetes, all of which result in a high blood sugar. As yet, there is no single genetic test to determine who is at risk for type 2 diabetes. To develop type 2 diabetes, you must be born with the genetic traits for diabetes. Because there is a wide range of genetic causes, there is also a wide range in how you will respond to treatment. You may be easily treated with just a change in diet or you may need multiple types of medication. The ha Continue reading >>

Insulin Resistance

Insulin Resistance

Insulin resistance (IR) is a pathological condition in which cells fail to respond normally to the hormone insulin. The body produces insulin when glucose starts to be released into the bloodstream from the digestion of carbohydrates in the diet. Normally this insulin response triggers glucose being taken into body cells, to be used for energy, and inhibits the body from using fat for energy. The concentration of glucose in the blood decreases as a result, staying within the normal range even when a large amount of carbohydrates is consumed. When the body produces insulin under conditions of insulin resistance, the cells are resistant to the insulin and are unable to use it as effectively, leading to high blood sugar. Beta cells in the pancreas subsequently increase their production of insulin, further contributing to a high blood insulin level. This often remains undetected and can contribute to the development of type 2 diabetes or latent autoimmune diabetes of adults.[1] Although this type of chronic insulin resistance is harmful, during acute illness it is actually a well-evolved protective mechanism. Recent investigations have revealed that insulin resistance helps to conserve the brain's glucose supply by preventing muscles from taking up excessive glucose.[2] In theory, insulin resistance should even be strengthened under harsh metabolic conditions such as pregnancy, during which the expanding fetal brain demands more glucose. People who develop type 2 diabetes usually pass through earlier stages of insulin resistance and prediabetes, although those often go undiagnosed. Insulin resistance is a syndrome (a set of signs and symptoms) resulting from reduced insulin activity; it is also part of a larger constellation of symptoms called the metabolic syndrome. Insuli Continue reading >>

Insulin Resistance, The Metabolic Syndrome, And Complication Risk In Type 1 Diabetes

Insulin Resistance, The Metabolic Syndrome, And Complication Risk In Type 1 Diabetes

“Double diabetes” in the Diabetes Control and Complications Trial Abstract OBJECTIVE—The presence of insulin resistance and the metabolic syndrome are known risk markers for macrovascular disease in patients with and without type 2 diabetes. This study has examined whether these also were predictors of micro- and macrovascular complications in type 1 diabetic patients participating in the Diabetes Control and Complications Trial (DCCT). RESEARCH DESIGN AND METHODS—International Diabetes Federation (IDF) criteria were used to identify the metabolic syndrome in 1,337 Caucasian DCCT patients at baseline. Insulin resistance was calculated using their estimated glucose disposal rate (eGDR). Insulin dose (units/kg) was also used as a separate marker of insulin resistance. RESULTS—The eGDR (but not insulin dose or metabolic syndrome) at baseline strongly predicted the development of retinopathy, nephropathy, and cardiovascular disease (hazard ratios 0.75, 0.88, and 0.70, respectively, per mg · kg−1 · min−1 change; P < 0.001, P = 0.005, and P = 0.002, respectively). Through mainly weight gain, the prevalence of the metabolic syndrome increased steadily from baseline to year 9 in conventionally treated (from 15.5 to 27.2%) and especially in the intensively treated (from 13.7 to 45.4%) patients. CONCLUSIONS—Higher insulin resistance at baseline in the DCCT (as estimated by eGDR) was associated with increased subsequent risk of both micro- and macrovascular complications. Insulin dose and the presence of IDF-defined metabolic syndrome were poor predictors by comparison. Although intensive treatment was associated with a higher subsequent prevalence of metabolic syndrome, the benefits of improved glycemia appear to outweigh the risks related to development of the Continue reading >>

Adiponectin Dysregulation And Insulin Resistance In Type 1 Diabetes

Adiponectin Dysregulation And Insulin Resistance In Type 1 Diabetes

The Journal of Clinical Endocrinology & Metabolism Adiponectin Dysregulation and Insulin Resistance in Type 1 Diabetes Denver Health and Hospital Authority (R.I.P.), Denver, Colorado 80204 Division of Endocrinology, Metabolism, and Diabetes (R.I.P., C.E., I.E.S., B.C.B.), Aurora, Colorado 80045 Address all correspondence and requests for reprints to: Rocio I. Pereira, M.D., University of Colorado, Anschutz Medical Campus, Division of Endocrinology, MS 8106, Aurora, Colorado 80045-0511. Search for other works by this author on: Barbara Davis Center for Childhood Diabetes (J.K.S.-B., M.R., D.M.M.), University of Colorado, Anschutz Medical Campus, Aurora, Colorado 80045 Search for other works by this author on: Division of Endocrinology, Metabolism, and Diabetes (R.I.P., C.E., I.E.S., B.C.B.), Aurora, Colorado 80045 Search for other works by this author on: Division of Endocrinology, Metabolism, and Diabetes (R.I.P., C.E., I.E.S., B.C.B.), Aurora, Colorado 80045 Denver Veterans Affairs Medical Center (I.E.S.), Denver, Colorado 80220 Search for other works by this author on: Division of Endocrinology, Metabolism, and Diabetes (R.I.P., C.E., I.E.S., B.C.B.), Aurora, Colorado 80045 Search for other works by this author on: Barbara Davis Center for Childhood Diabetes (J.K.S.-B., M.R., D.M.M.), University of Colorado, Anschutz Medical Campus, Aurora, Colorado 80045 Search for other works by this author on: Barbara Davis Center for Childhood Diabetes (J.K.S.-B., M.R., D.M.M.), University of Colorado, Anschutz Medical Campus, Aurora, Colorado 80045 Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 97, Issue 4, 1 April 2012, Pages E642E647, Rocio I. Pereira, Janet K. Snell-Bergeon, Christopher Erickson, Irene E. Schauer, Bryan C. Continue reading >>

Insulin Resistance In Type 1 Diabetes Mellitus - Sciencedirect

Insulin Resistance In Type 1 Diabetes Mellitus - Sciencedirect

Volume 64, Issue 12 , December 2015, Pages 1629-1639 Author links open overlay panel KirtiKaulab1 MariaApostolopoulouab1 MichaelRodenabc Get rights and content For long the presence of insulin resistance in type 1 diabetes has been questioned. Detailed metabolic analyses revealed 12%61% and up to 20% lower whole-body (skeletal muscle) and hepatic insulin sensitivity in type 1 diabetes, depending on the population studied. Type 1 diabetes patients feature impaired muscle adenosine triphosphate (ATP) synthesis and enhanced oxidative stress, predominantly relating to hyperglycemia. They may also exhibit abnormal fasting and postprandial glycogen metabolism in liver, while the role of hepatic energy metabolism for insulin resistance remains uncertain. Recent rodent studies point to tissue-specific differences in the mechanisms underlying insulin resistance. In non-obese diabetic mice, increased lipid availability contributes to muscle insulin resistance via diacylglycerol/protein kinase C isoforms. Furthermore, humans with type 1 diabetes respond to lifestyle modifications or metformin by 20%60% increased whole-body insulin sensitivity, likely through improvement in both glycemic control and oxidative phosphorylation. Intensive insulin treatment and islet transplantation also increase but fail to completely restore whole-body and hepatic insulin sensitivity. In conclusion, insulin resistance is a feature of type 1 diabetes, but more controlled trials are needed to address its contribution to disease progression, which might help to optimize treatment and reduce comorbidities. Continue reading >>

Insulin Resistance And Associated Factors In Patients With Type 1 Diabetes

Insulin Resistance And Associated Factors In Patients With Type 1 Diabetes

Abstract To assess the presence of insulin resistance (IR) in patients with type 1 diabetes (T1DM) according to the estimated glucose disposal rate formula (eGDR) and the insulin sensitivity score (ISS) and to estimate the correlation between these two measures and identify the clinical and laboratory markers related to IR. Cross-sectional study of adults with T1DM (n = 135). The results of the formulas that estimate IR were separated into quartiles and correlated with demographic data, clinical characteristics and laboratory parameters. We analyzed the total and regional adiposity by dual-energy X-ray absorptiometry and skin fold thickness measurements. Two thirds of the patients were overweight or obese. A moderate correlation was found between eGDR and ISS (r = 0.612). The results of both formulas were positively correlated with BMI (r = −0.373 eGDR and r = −0.721 ISS), thoracic-abdominal fat (r = −0.484 eGDR and r = −0.758 ISS), waist/height ratio (r = −0.537 eGDR and r = −0.779 ISS), subscapular skinfold (mm) (r = −0.356 eGDR and r = −0.569 ISS), total dose insulin IU/lean mass (kg) (r = −0.279 eGDR and r = −0.398 ISS), age (years) (r = −0.495 eGDR and r = −0.190 ISS) and diabetes duration (years) (r = −0.428 eGDR and r = −0.187 ISS). A moderate agreement (Kappa 0.226) was observed between the 1st quartile of results determined by the formulas in 10.4% of the patients, but the 4th quartile presented a strong correlation (Kappa 0.679). The individuals with IR that were classified in the 1st quartile by the ISS formula had a higher chance of presenting with acanthosis nigricans (OR = 5.58, 95% CI =1.46-21.3). The correlations found in this study indicate the possibility of using clinical and laboratory data to estimate IR in patients with Continue reading >>

Insulin Resistance In Type 1 Diabetes: What Is ‘double Diabetes’ And What Are The Risks?

Insulin Resistance In Type 1 Diabetes: What Is ‘double Diabetes’ And What Are The Risks?

Go to: Double diabetes The term ‘double diabetes’ was first coined in 1991 based on the observation that patients with type 1 diabetes who had a family history of type 2 diabetes were more likely to be overweight and rarely achieved adequate glycaemic control even with higher insulin doses [1]. The more extensive, or stronger, the family history, the higher the dose the patient received. The authors suggested that this might indicate the presence of increased resistance to insulin-mediated glucose disposal in this subgroup of people with type 1 diabetes and asserted that, over a lifetime, some of these individuals would likely have been diagnosed with type 2 diabetes at some point, had they not first developed beta cell destruction by an independent pathological process (i.e. type 1 diabetes). At this stage, it is important to differentiate this description of double diabetes, which considers autoimmune diabetes to be an independent process from obesity and insulin resistance, from the accelerator hypothesis [2], which describes triggering of autoimmune diabetes by factors including BMI and insulin resistance. Other studies of people with type 1 diabetes and a family history of type 2 diabetes have supported the notion that this combination might promote both microvascular and macrovascular complications of type 1 diabetes. For example, in a prospective study of 3250 patients with type 1 diabetes recruited from 16 European countries (EURODIAB), it was demonstrated that women with a parental history of type 2 diabetes had a higher risk of developing albuminuria than those without a positive family history (HR 1.36, p = 0.04) [3]. Furthermore, in a cross-sectional study of 658 patients from the Pittsburgh Epidemiology of Diabetes Complications (EDC) cohort, 112 of who Continue reading >>

Insulin Resistance Causes And Symptoms

Insulin Resistance Causes And Symptoms

One in three Americans—including half of those age 60 and older1— have a silent blood sugar problem known as insulin resistance. Insulin resistance increases the risk for prediabetes, type 2 diabetes and a host of other serious health problems, including heart attacks, strokes2 and cancer.3 What is Insulin Resistance? Insulin resistance is when cells in your muscles, body fat and liver start resisting or ignoring the signal that the hormone insulin is trying to send out—which is to grab glucose out of the bloodstream and put it into our cells. Glucose, also known as blood sugar, is the body’s main source of fuel. We get glucose from grains, fruit, vegetables, dairy products, and drinks that bring break down into carbohydrates. How Insulin Resistance Develops While genetics, aging and ethnicity play roles in developing insulin sensitivity, the driving forces behind insulin resistance include excess body weight, too much belly fat, a lack of exercise, smoking, and even skimping on sleep.4 As insulin resistance develops, your body fights back by producing more insulin. Over months and years, the beta cells in your pancreas that are working so hard to make insulin get worn out and can no longer keep pace with the demand for more and more insulin. Then – years after insulin resistance silently began – your blood sugar may begin to rise and you may develop prediabetes or type 2 diabetes. You may also develop non-alcoholic fatty liver disease (NAFLD), a growing problem associated with insulin resistance that boosts your risk for liver damage and heart disease. 5 Signs and Symptoms of Insulin Resistance Insulin resistance is usually triggered by a combination of factors linked to weight, age, genetics, being sedentary and smoking. - A large waist. Experts say the be Continue reading >>

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