İnsülin Direnci ve Klinik Önemi

İnsülin metabolizmanın düzenleyici temel hormonlarından biridir. İnsülinin keşfi için uzun asırlar boyu süren araştırmalar mevcuttur. Bilim adamlarını insülini araştırmaya iten sebep insülin direncinin ortaya çıkardığı hastalıklardır. İnsülin direnci, karmaşık bir patogeneze sahiptir. İnsülin direncinin patogenezi halen tam olarak aydınlatılamamıştır ve araştırılmaktadır. Obezite ile insülin direnci arasında çok güçlü bir ilişki bulunmaktadır. İnsülin direncinin en sık sebebi obezitedir. İnsülin direnci ortaya çıktığında hemen klinik belirti vermeyebilir. Subklinik dönemde diyet düzenlenmesi ve egzersizi içeren yaşam tarzı değişiklikleri ve kilo verilmesi ile insülin direnci gerileyebilir. İnsülin direncine müdahale edilmediğinde, uzun dönemde birçok hastalığa sebep olabilir. Kardiyovasküler hastalık riski artar. Endotel fonksiyonu bozulur. Tip 2 Diyabetes Mellitus gelişir. Metabolik sendrom sıklığı gittikçe artmaktadır. Metabolik sendromun en önemli bileşeni insülin direncidir. İnsülin direncinin ölçümü için altın standart olan metot, öglisemik hiperinsülinemik klemp metodudur. Bu metodun zahmetli ve pahalı olması sebebiyle HOMA (Homeostasis Model Assessment) metodu kullanılmaktadır. HOMA formülü açlık serum glikozu ve açlık serum insülini değerleri ile hesaplamaya dayanır. İnsülin direnci varlığında, yaşam tarzı değişiklikleri ile insülin direncini geriletme hedeflenir. Şayet geriletilemeyecek duruma gelmiş ve klinik problemler ortaya çıkmışsa hastalığa uygun ilaç tedavisi verilebilir. İnsülin direnci temelinde ortaya çıkan hastalıkların medikal tedavisine ek olarak yaşam tarzı değişiklikleri ilaçların etkinliğini arttırmaktadır. İnsülin direncine karşı yapılacak yaşam tarzı değişiklikleri, kilo verilmesi, diyet düzenlenmesi ve düzenli egzersiz olarak sayılabilir.

Insulin Resistance and Clinical Significance

Insulin is one of the basic editor hormones of metabolism. There are many researches for the discovery of insulin, based on many centuries. The reasons of scientists' insulin researches are the relation of clinical disease with insulin resistance. Insulin resistance has a complex pathogenesis. The pathogenesis of insulin resistance has not been fully clarified and investigated. Insulin resistance has a strong relation with obesity. The most common cause of insulin resistance is obesity. When Insulin resistance occured, it might not immediately show the clinical symptoms. Subclinical term regulation of diet and lifestyle that includes exercise and weight changes can be decreased by the administration of insulin resistance. If we don't regulate insulin resistance, it may cause many diseases in the long term. The risk of cardiovascular disease was increased in insulin resistance. Endothelial function is impaired. Type 2 diabetes mellitus develops. Prevalence of metabolic syndrome is increasing. The most important component of the metabolic syndrome is insulin resistance. The gold standard for the measurement of insulin resistance method is a method euglycemic hyperinsulinemic clamp. This method is laborious and expensive due to the HOMA (Homeostasis Model Assessment) method is used. HOMA are based on calculations with fasting serum glucose and fasting serum insulin values. With lifestyle changes aimed towards insulin resistance is decreased. If the regression becomes unable to diseases and clinical problems arise we can give appropriate medication. On the basis of insulin resistance in addition to the medical treatment of diseases associated lifestyle changes increases the effectiveness of drugs. Insulin resistance can be done against lifestyle changes, weight management, diet and regular exercise may be considered.

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