What is the biochemistry of insulin resistance

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Type 2 diabetes

This form of diabetes mellitus, in which sufficient insulin is produced but the insulin cannot work properly in the body, affects around 90% of all diabetics. These are mainly overweight patients who are insulin resistant, i.e. the cells in the body no longer react to the hormone and, despite sufficient insulin production, no longer absorb glucose from the blood into the cells. Reasons for this insulin resistance are, for example, the reduced expression of insulin receptors or a lower enzyme activity on the insulin receptor. The insulin level is initially increased in the course of the disease in order to compensate for the inadequate effect of the hormone, but in the long term the insulin secretion is also disturbed. Glucagon secretion can also be increased. The pancreas, on the other hand, has hardly changed morphologically.

The factors that favor type 2 diabetes include obesity (obesity), pregnancy (gestational diabetes; however, the disease here is usually only temporary), liver damage or hormonal disorders in which the hormones cortisone or glucagon increase be secreted. In most cases, the patients are older than 40 years, which is why this type of diabetes was also known as "adult diabetes" in the past.

Heredity also plays an important role in type 2 diabetes. It is still not clear how many metabolic or diabetes genes are actually involved in this clinical picture, but there are definitely many different factors. In addition, there are environmental factors that influence genetic predisposition. If one twin has type 2 diabetes mellitus, the second twin is also affected in 90-100% of all cases. Children with one parent with type 2 diabetes have a 40% risk of developing the disease as well.