Insulin Resistance as a Disease of Civilization

Abstract

Civilization - related diseases can be defined as those caused by the effects of harmful factors resulting from the development of civilization, the progressive industrialization and changes in lifestyle that derive from the use of achievements of modern civilization. Abdominal obesity and diabetes are the most typical examples of such ailments.

Insulin resistance underpins the obesity and type 2 diabetes’ twin epidemics and explains many of the metabolic problems that, linked together, are called a metabolic syndrome. It is defined as a glucose homeostasis disorder, in terms of reduced sensitivity of muscle, fat, liver and other body tissues to insulin. There are three possible mechanisms of insulin resistance: pre-receptor, receptor and post-receptor.

Insulin resistance may not be the only and the basic problem of the patient directly leading to impaired glucose metabolism in the form of diabetes. It may be an additional issue, related to another disease the patient is suffering from, and leading to serious complications, including diabetes. This is due to a variety of hormonal disorders occurring in various diseases and leading to the emergence of resistance to insulin.

Most of the hormones diminish the effect of insulin in the body in the mechanism of action of the liver and the peripheral tissues. The hormones that in excess most often cause carbohydrate metabolism disorders include growth hormone, thyroxine, glucocorticoids, catecholamine, parathyroid hormone, aldosterone, glucagon and somatostatin. The effect of their activity is hyperinsulinemia resulting from the compensatory rise in insulin secretion in response to increasing insulin resistance.

The awareness of insulin resistance prevalence in different globally widely spread disease entities and the understanding of the mechanisms leading to it should contribute to taking better care of patients originally being treated because of other reasons.