Memnune Sena ULU, Şeref YÜKSEL

34943

İnsülin Direnci

İnsülin direnci (İR), önemli bir morbidite nedenidir. Hareketsiz yaşam tarzı ve beslenme alışkanlığının yanında, genetik özellikler de rol oynamaktadır. İR, obezite, hipertansiyon ve hiperlipidemi ile ilişkisi nedeniyle ciddi önem taşımaktadır. Sağlıklı populasyonda % 25 oranında İR görülür. Bu direnç, öglisemiyi sağlayabilmek icin hiperinsülinemiyle karşılanmaya çalışılır. İR’nin gösterilmesi tip 2 diyabet ve/veya kardiyovasküler hastalık riskinin tanımlanması açısından klinik önem taşır. İR’nin ölçülmesinde HOMA ve QUICKI güvenilir metodlardır. Tedavi; diyet, egzersiz ve kilo kaybından oluşan yaşam tarzı değişikliğidir. Diyet ve egzersiz yeterli olmadığında ilaç tedavisi iyi bir seçenektir.
Anahtar Kelimeler:

İnsülin direnci, obezite, hipertansiyon, tip 2 diyabet

Insulin Resistance

Insulin resistance (IR) is an important cause ofnmorbidity. Sedentary lifestyle, dietary habitsnand heredity plays role. IR becomes more important when its relationship with obesity, hypertension, and hyperlipidemia is considered.nIt can be seen in 25% of the healthy population. IR is tried to be tolerated with hyperinsulinemia to achieve euglycemia. It is clinially importantnto identify the type 2 diabetesnrisk and /or cardiovascular disease. HOMA andnQUICKI are reliable methods to measure IR.nTreatment is modulation of life style includingdiet. The medical treatment is a good optionnwhen diet and exercise do not work.
Keywords:

Insulin resistance, obesity, hypertension, type 2 diabetes,

PDF

___

  • Gulli G, Ferrannini E, Stern M, et al. The metabolic profile of NIDDM is fully established in glucose- tolerant offspring of two Mexican-American NIDDM parents. Diabetes 1992;41(12):1575-86.
  • Saad MF, Knowler WC, Pettit DJ, et al. A two step model for development of non-insulin dependent diabetes mellitus. Am J Med 1991;90(2):229-35.
  • Hollenbeck C, Reaven GM. Variations in insulin stimulated glucose uptake in healthy individuals with normal glucose tolerance. J Clin Endocrinol Metab 1987;64(6):1169-73.
  • Scott M, Grundy MD, James I, et al. Diagnosis and management of the metabolic syndrome. Circulation 2005;112(17):2735-52.
  • Yenigün M (Editör). İnsülin direnci ve ölçüm metodları. In: Altuntaş Y. Her yönüyle diabetes mellitus. 2nci Baskı, İstanbul: Nobel Tıp Kitapevi, 2001:839-52.
  • Trichitta V, Brunetti A, Chiavetta A, et al. Defects Stroke 1997;28(5):999-1005.
  • Juhan-Vauge I, Alessi MC. Fibrinolysis and risk of coronary artery disease. Fibrinolysis 1996;10(1):127
  • Kohler HP. Insulin resistance syndrom: interaction with coagulation and fibrinolysis. Swiss Med Wkly 2002;132(19-20):241-52.
  • Gerenli M, Tuğrul A, Demir M, et al. The rela- tionship between proinflammatory cytokine levels and fibrinolytic system in obese patients. Balkan trial. Lancet 2006;368(9549):1096–105. Med J 2008;25(1):44-51.
  • Al-Karkhi IH, Ibrahim AE, Yaseen AK. Levels of Insulin, IL-6 and CRP in patients with unstable angina. Adv Clin Exp Med 2013;22(5):655-8.
  • Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112(17):2735–52.
  • Swinburn BA, Boyce VL, Bergman RN, et al. Deterioration in carbohydrate metabolism and lipoprotein changes induced by modern high fat diet in Pima Indians and Caucasians. J Clin Endocrinol Metab 1991;73(1):156-65.
  • Mayer-Davis EJ, Monaco JH, Hoen HM, et al. Dietary fat and insulin sensitivity in a triethnic population: the role of obesity. The Insulin Resistance Atherosclerosis Study (IRAS). Am J Clin Nutr 1997;65(1):79-87.
  • Thorell A, Hirshman MF, Nygren J, et al. Exercise and insülin cause GLUT-4 translocation in human skeletal muscle. Am J Physiol 1999;277(4):733-41.
  • Stumvoll M, Nurjhan N , Perriello G, et al. Metabolic effects of metformin in non-insülindependent diabetes mellitus. The New England Journal of Medicine 1995;333(9):550-4.
  • Fischer S, Bornstein SR. New oral antidiabetic agents—clinical perspectives. Internist (Berl) 2008;49(4):495-501.
  • Gerstein HC, Yusuf S, Bosch J, et al. DREAM (Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication) Trial Investigators: effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomized controlled
Kocatepe Tıp Dergisi-Cover
  • ISSN: 1302-4612
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1999
Arşiv
Sayıdaki Diğer Makaleler

İnsülin Direnci

Memnune Sena ULU, Şeref YÜKSEL