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Syndrome of insulin resistence. Study and managment, Like, LEONARDO CARO…
Syndrome of insulin resistence. Study and managment
Metabolic syndrome
insulin resistance syndrome
Anabolic hormone that in this syndrome its action is reduced at the cellular level
Promoting insulin secretion
Creating a hyperglycemic state
Pathogenic factors of insulin resistance
Inflammation-mediated insulin resistance
Increased inflammatory factors and circulating leukocytes
Adipocytes, endothelial cells, leukocytes, liver cells, pancreatic cells, neurons.
Show increased binding of proinflammatory transcription factors
Lipid-mediated insulin resistance
Lipids can induce IR
Accumulate in ectopic tissues
Lower mitochondrial density and ATP synthesis
Skeletal muscle
circulating free fatty acids
Bind to membrane receptors
Release of proinflammatory cytokines
Evaluation of insulin resistance
HOMA-IR (Homeostasis Model Assessment of Insulin Resistance)
HOMA-IR = fasting blood glucose (mg/dL) x basal insulin (uU/mL) / 405
Antoher methods
Modified Frequent Sampling Intravenous Glucose Tolerance Test (FSIVGTT)
Extraction of venous blood samples on 30 occasions during a period of 3 hours
Assesses both secretion and sensitivity to insulin
Urinary excretion of C-peptide (molecule co-secreted with insulin)
Related to food intake
Like a physiological indicator of IR
Evaluation by insulinemia curve
Oral glucose tolerance 75g
Insulin Resistance
10 and 60 uU/mL
After 2hr less than 140 mg/dL
Matsuda
5 measurements
Insulin Resistance Value < 2.5
Adipose tissue: Central organ in inflammation and insulin resistance
Adipocytes
Increased synthesis and release of adipokines
Impairs lipid and glucose metabolism
Inflammatory or thrombotic effect
They influence the metabolic alteration
Obesity and Insulin Resistence
Nutritional management of metabolic syndrome with emphasis on insulin resistance
Limit large intakes of fat
Increase fruits and vegetables
Mediterranean diet
Physical exercise
Hipocaloric diet
Reduce high glycemic index foods
Pharmacological Management
Syndrome metabolic
Adaptation to the Subject
Hipolipemiantes (lipid-lowering)
Oral Anti-Diabetics
Anti-obesity
Sibutramina
Rimonabant
Insulin Resistance
Insulin-Sensitizing Drugs in Diabetes Type 2
The most used is metmorfina
Tiazolidinedionas (rosigli-tazona, pioglitazona)
Pharmacological therapies reduce the risk of type 2 diabetes
Therapy based on lifestyle changes is usually the most effective
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LEONARDO CARO TRUJILLO
MATEO PRADA SALAZAR
