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INSULIN RESISTANCE

intro. the requirement of 200 or more units of insulin per day to attain glycemic control and prevent ketosis. The mechanisms that are responsible for the insulin resistance syndromes (IRS) include genetic or primary target cell defects, autoantibodies to insulin, and accelerated insulin degradatio

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INSULIN RESISTANCE

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    1. INSULIN RESISTANCE Saad almohizea

    2. intro the requirement of 200 or more units of insulin per day to attain glycemic control and prevent ketosis. The mechanisms that are responsible for the insulin resistance syndromes (IRS) include genetic or primary target cell defects, autoantibodies to insulin, and accelerated insulin degradation.

    3. Hypoglycemia? Hypoglycemia: Some patients present with symptoms of hypoglycemia ,results from interaction between insulinomimetic antibodies and insulin receptor. A group of patients exists with insulin-binding antibodies directed against insulin, which, upon dissociation, can cause hypoglycemia Two major variants of insulin receptor abnormalities that are associated with acanthosis nigricans have been described

    4. CAUSES Obesity PCOD Leprechaunism - Lipodystrophic states -. Werner syndrome – Rabson-Mendenhall syndrome – Pineal hypertrophic syndrome - Alstrom syndrome Immune insulin resistance Low titer immunoglobulin (Ig) G anti-insulin antibodies are present in most patients receiving insulin. Cushing syndrome and acromegaly

    5. lipodysrophies Dunnigan kuberling syndrome Generalised lipodystrophy: 1.Berardenille-seip syndrome 2.Seip- lawerence sundrome

    6. mechanism Prereceptor Abnormal insulin (mutations) Anti-insulin antibodies Receptor Decreased number of receptors, mainly failure to activate tyrosine kinase Reduced binding of insulin Insulin receptor mutations Insulin receptor–blocking antibodies Postreceptor Defective signal transduction

    7. Drug induced Medications associated with IRS include glucocorticoids Cyclosporine niacin and the protease inhibitors. HIV-protease inhibitor–associated lipodystrophy is a recognized entity

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