Insulin resistance

Insulin resistance
Specialty	Endocrinology
Complications	Nonalcoholic fatty liver disease, vascular disease.
Duration	10 to 15 years before developing type 2 diabetes.
Causes	Lipotoxicity, use of glucocorticoids, anti-adrenergic, protease inhibitors, selective serotonin reuptake inhibitors, atypical antipsychotics.
Risk factors	Hyperinsulinemia
Diagnostic method	Glucose challenge test, Glucose clamp technique.
Prognosis	Hyperglycemia, hypertension, dyslipidemia, hyperuricemia, elevated inflammatory markers, endothelial dysfunction, a prothrombotic state, and polyendocrine metabolic ovarian syndrome (PMOS).

Insulin resistance (IR) is a pathological response in which cells in insulin-sensitive tissues in the body fail to respond normally to the hormone insulin or downregulate insulin receptors in response to hyperinsulinemia. Insulin resistance is a major cause of type 2 diabetes.

Insulin is a hormone that facilitates the transport of glucose from blood into cells, thereby reducing blood glucose (blood sugar). Insulin is released by the pancreas in response to carbohydrates consumed in the diet. In states of insulin resistance, the same amount of insulin does not have the same effect on glucose transport and blood sugar levels. There are many causes of insulin resistance and the underlying process is still not completely understood. Risk factors for insulin resistance include obesity, sedentary lifestyle, family history of diabetes, various health conditions, and certain medications. Insulin resistance is considered a component of the metabolic syndrome. Insulin resistance can be improved or reversed with lifestyle approaches, such as weight reduction, exercise, and dietary changes.

Techniques to test for the presence or extent of insulin resistance include measurement of fasting insulin levels, the hyperinsulinemic euglycemic clamp technique, the modified insulin suppression test and static function tests. These methods are not often used in clinical practice.