Insulin resistance - Knowledge (XXG)

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altering reproductive and behavioral strategies. These strategies are termed "r to K" and "soldier to diplomat." The "r to K" strategy involves directing insulin through the placenta to the fetus, resulting in weight gain in the fetus but not the mother, indicating an increase in parental investment (K strategy). In the "soldier to diplomat" strategy, the insensitivity of skeletal muscle to insulin could redirect glucose to the brain, which does not require insulin receptors. This has been shown to enhance cognitive development across various studies.

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sensitivity tuning (including sensitivity reduction) is a common practice for an organism to adapt to the changing environment or metabolic conditions. Pregnancy, for example, entails significant metabolic changes, during which the mother must decrease the insulin sensitivity of her muscles to conserve more glucose for both the maternal and fetal brains. This adaptation can occur by elevating the response threshold, thereby delaying the onset of sensitivity. This is achieved through the secretion of

839:(0.27 μg/m/min) to suppress endogenous insulin and glucose secretion. Next, insulin and 20% glucose are infused at rates of 32 and 267 mg/m/min, respectively. Blood glucose is checked at zero, 30, 60, 90, and 120 minutes, and thereafter, every 10 minutes for the last half-hour of the test. These last four values are averaged to determine the steady-state plasma glucose level (SSPG). Subjects with an SSPG greater than 150 mg/dL are considered to be insulin-resistant. 917:

fasting insulin reduction; however, resistance and combined exercise are not. The authors caution against demeaning the importance of resistance and combined exercise, as this type of training is generally less researched than aerobic training. Overall, physical training can be used in both adolescents and adults to prevent the progression of insulin resistance and future possible metabolic and cardiovascular disease.

25: 117: 617:-1 and −6, etc. In numerous experimental models, these proinflammatory cytokines disrupt normal insulin action in fat and muscle cells and may be a major factor in causing the whole-body insulin resistance observed in patients with visceral adiposity. Much of the attention on production of proinflammatory cytokines has focused on the IKK-beta/ 815:

hyperinsulinemic phase, a 3-hour tracer infusion allows for the determination of the basal rate of glucose production. Throughout the clamp, the plasma tracer concentrations facilitate the computation of whole-body insulin-stimulated glucose metabolism, as well as the production of glucose by the body. (i.e., endogenous glucose production).

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Several genetic loci have been identified as associated with insulin insensitivity. These include variations in loci near the NAT2, GCKR, and IGFI genes, which are linked to insulin resistance. Further research has indicated that loci near these genes are correlated with insulin resistance. However,

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serves as a socio-ecological adaptation, with insulin serving as the mechanism for allocating energy to different body components and insulin sensitivity being an adaptation to regulate this energy allocation. The Behavioral Switch Hypothesis suggests that insulin resistance leads to two methods of

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or disease, but rather as the normal, physiologic response to sustained caloric surplus... As a consequence of the high level of lipid accumulation in insulin target tissues including skeletal muscle and liver, it has been suggested that exclusion of glucose from lipid-laden cells is a compensatory

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Furthermore, physical training has also generally been seen to be an effective antagonist of insulin resistance in obese or overweight children and adolescents (under the age of 19). As per the 2016 systematic review and meta-analysis conducted by Marson et al., aerobic exercise is associated with

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This fundamental technique can be greatly enhanced through the utilization of glucose tracers. Glucose can be labeled with either stable or radioactive atoms. Commonly employed tracers include 3-3H glucose (radioactive), 6,6 2H-glucose (stable), and 1-13C glucose (stable). Prior to initiating the

221:. There are multiple ways to measure insulin resistance such as fasting insulin levels or glucose tolerance tests, but these are not often used in clinical practice. Insulin resistance can be improved or reversed with lifestyle approaches, such as weight reduction, exercise, and dietary changes. 912:

at reducing the risk of progressing to type 2 diabetes. However, the participants in the DPP trial regained about 40% of the weight that they had lost at the end of 2.8 years, resulting in a similar incidence of diabetes development in both the lifestyle intervention and the control arms of the

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is upregulated, insulin levels are higher, and blood glucose levels are still maintained. If compensatory insulin secretion fails, then either fasting (impaired fasting glucose) or postprandial (impaired glucose tolerance) glucose concentrations increase. Eventually, type 2 diabetes occurs when

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The insulin sensitivity is determined by the rate of glucose infusion during the last thirty minutes of the test. If high levels (7.5 mg/min or higher) are needed, the patient is considered insulin-sensitive. Conversely, very low levels (4.0 mg/min or lower) indicate insulin resistance. Levels

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of that initial portion of the small intestine that signals body cells to become insulin resistant. If the producing tissue is removed, the signal ceases and body cells revert to normal insulin sensitivity. No such substance has been found as yet, and the existence of such a substance remains

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switch under physiologic conditions for certain types of cells, and insulin response may well be a threshold phenomenon. The pathway's sensitivity to insulin may be blunted by many factors such as lipolysis of free fatty acids, causing insulin resistance. From a broader perspective, however,

982:. This hypothesis raises the point that if there is a genetic component to insulin resistance and Type 2 diabetes, these phenotypes should be selected against. Yet, there has been an increase in mean insulin resistance in both the normoglycemic population as well as the diabetic population. 301:(PUFAs) is inversely correlated with insulin resistance. It is hypothesized that increasing cell membrane fluidity by increasing PUFA concentration might result in an enhanced number of insulin receptors, an increased affinity of insulin to its receptors, and reduced insulin resistance. 748:(OGTT) may be normal or mildly abnormal in simple insulin resistance. Often, there are raised glucose levels in the early measurements, reflecting the loss of a postprandial peak (after the meal) in insulin production. Extension of the testing (for several more hours) may reveal a 461:, genetic factors, aging, and reduced mitochondrial biogenesis. Important questions remain unsolved to date, however. If confirmed by rigorous studies, a link between mitochondrial disorders and reduced insulin sensitivity might pave the way to new therapeutic approaches. 586:

glucose levels become higher as the resistance increases and compensatory insulin secretion fails. The inability of the β-cells to produce sufficient insulin in a condition of hyperglycemia is what characterizes the transition from insulin resistance to type 2 diabetes.

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consumed in the diet. In states of insulin resistance, the same amount of insulin does not have the same effect on glucose transport and blood sugar levels. There are many causes of insulin resistance and the underlying process is still not completely understood.

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Dietary factors are likely to contribute to insulin resistance. However, causative foods are difficult to determine given the limitations of nutrition research. Foods that have independently been linked to insulin resistance include those high in sugar with high

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Evidence contradicts Neel's hypothesis in studies of the Pima Indians, which suggest that individuals with higher insulin sensitivity tended to have higher weights, whereas those with insulin resistance tended to weigh less on average within this demographic.

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normally helps regulate glucose levels by reducing its secretion of glucose in the presence of insulin. However, in insulin resistance, this normal reduction in the liver's glucose production may not occur, further contributing to elevated blood glucose.

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Marson EC, Delevatti RS, Prado AK, Netto N, Kruel LF (December 2016). "Effects of aerobic, resistance, and combined exercise training on insulin resistance markers in overweight or obese children and adolescents: A systematic review and meta-analysis".

605:(HDL) cholesterol levels. With respect to visceral adiposity, a great deal of evidence suggests two strong links with insulin resistance. First, unlike subcutaneous adipose tissue, visceral adipose cells produce significant amounts of proinflammatory 688:

that acts as an antioxidant defense mechanism. This link seems to exist under diverse causes of insulin resistance. It also is based on the finding that insulin resistance may be reversed rapidly by exposing cells to mitochondrial uncouplers,

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is a hormone produced from the ob gene and adipocytes. Its physiological role is to regulate hunger by alerting the body when it is full. Studies show that lack of leptin causes severe obesity and is strongly linked with insulin resistance.

780:. The test is rarely performed in clinical care, but is used in medical research, for example, to assess the effects of different medications. The rate of glucose infusion commonly is referred to in diabetes literature as the GINF value. 938:) may moderate the progression of insulin resistance into type 2 diabetes, however, omega-3 fatty acids appear to have limited ability to reverse insulin resistance, and they cease to be efficacious once type 2 diabetes is established. 985:

J.V. Neel posits that in ancient human ancestors, during periods of heightened famine, genes facilitating increased glucose storage would have conferred an advantage. However, in today's modern environment, this is no longer the case.

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Haugaard SB, Madsbad S, Høy CE, Vaag A (February 2006). "Dietary intervention increases n-3 long-chain polyunsaturated fatty acids in skeletal muscle membrane phospholipids of obese subjects. Implications for insulin sensitivity".

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pathway, a protein network that enhances transcription of inflammatory markers and mediators that may cause insulin resistance. Second, visceral adiposity is related to an accumulation of fat in the liver, a condition known as

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which provides energy as well as lowers blood glucose. The beta cells reduce insulin output as the blood glucose level falls, allowing blood glucose to settle at a constant of approximately 5 mmol/L (90 mg/dL). In an

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at Stanford University. The test correlates well with the euglycemic clamp, with less operator-dependent error. This test has been used to advance the large body of research relating to the metabolic syndrome.

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Garrido-Sanchez L, Murri M, Rivas-Becerra J, Ocaña-Wilhelmi L, Cohen RV, Garcia-Fuentes E, Tinahones FJ (2012). "Bypass of the duodenum improves insulin resistance much more rapidly than sleeve gastrectomy".

1081: 246: 2149:"The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization outcome" 5090: 626:(NAFLD). The result of NAFLD is an excessive release of free fatty acids into the bloodstream (due to increased lipolysis), and an increase in hepatic breakdown of glycogen stores into glucose ( 566:, which tend to retain their sensitivity in the face of hepatic and skeletal muscle resistance, insulin resistance stimulates the formation of new fatty tissue and accelerates weight gain. 2188:

Milner KL, van der Poorten D, Trenell M, Jenkins AB, Xu A, Smythe G, et al. (March 2010). "Chronic hepatitis C is associated with peripheral rather than hepatic insulin resistance".

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When the body produces insulin under conditions of insulin resistance, the cells are unable to absorb or use it as effectively and it stays in the bloodstream. Certain cell types such as

722:(GTT), which may be used to diagnose diabetes mellitus, a fasting patient takes a 75 gram oral dose of glucose. Then blood glucose levels are measured over the following two hours. 3887:

Fukuchi S, Hamaguchi K, Seike M, Himeno K, Sakata T, Yoshimatsu H (June 2004). "Role of fatty acid composition in the development of metabolic disorders in sucrose-induced obese rats".

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Muniyappa R, Lee S, Chen H, Quon MJ (January 2008). "Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage".

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of the University College Hospital Medical Centre in London in 1936; however, type 2 diabetes does not occur unless there is concurrent failure of compensatory insulin secretion.

835:(Sandostatin) in 5 mL of normal saline over 3 to 5 minutes via intravenous infusion (IV) as an initial bolus, and then, are infused continuously with an intravenous infusion of 1912:

Piroli GG, Grillo CA, Reznikov LR, Adams S, McEwen BS, Charron MJ, Reagan LP (2007). "Corticosterone impairs insulin-stimulated translocation of GLUT4 in the rat hippocampus".

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improve insulin sensitivity. Metformin is approved for prediabetes and type 2 diabetes and has become one of the more commonly prescribed medications for insulin resistance.

238:. Various genetic factors can increase risk, such as a family history of diabetes, and there are some specific medical conditions associated with insulin resistance, such as 3705:

Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, Veerman JL, Delwiche K, Iannarone ML, Moyer ML, Cercy K, Vos T, Murray CJ, Forouzanfar MH (August 2016).

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Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, Veerman JL, Delwiche K, Iannarone ML, Moyer ML, Cercy K, Vos T, Murray CJ, Forouzanfar MH (August 2016).

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production rate in insulin-resistant subjects and type 2 diabetics. Insulin resistance often is found in people with visceral adiposity, hypertension, hyperglycemia, and

4746: 4078:"Failure of islet β-cell compensation for insulin resistance causes type 2 diabetes: what causes non-alcoholic fatty liver disease and non-alcoholic steatohepatitis?" 2654:

Koyama K, Chen G, Lee Y, Unger RH (October 1997). "Tissue triglycerides, insulin resistance, and insulin production: implications for hyperinsulinemia of obesity".

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Giebelstein, J; Poschmann, G; Højlund, K; Schechinger, W; Dietrich, JW; Levin, K; Beck-Nielsen, H; Podwojski, K; Stühler, K; Meyer, HE; Klein, HH (April 2012).

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Caprio S, Pierpont B, Kursawe R (March 2018). "The "adipose tissue expandability" hypothesis: a potential mechanism for insulin resistance in obese youth".

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A fasting serum insulin level greater than 29 microIU/mL or 174 pmol/L indicates insulin resistance. The same levels apply three hours after the last meal.

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less than 7.8 mmol/L (140 mg/dL) is considered normal, a glycemia of between 7.8 and 11.0 mmol/L (140 to 197 mg/dL) is considered as

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Ivy JL (November 1997). "Role of exercise training in the prevention and treatment of insulin resistance and non-insulin-dependent diabetes mellitus".

927:, has been shown to reduce insulin resistance in healthy individuals, in individuals with insulin resistance, and in individuals with type 2 diabetes. 660:

At the molecular level, a cell senses insulin through insulin receptors, with the signal propagating through a signaling cascade collectively known as

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Singh, Trisha; Ahmed, Tarig H; Mohamed, Nusyba; Elhaj, Mohamed S; Mohammed, Zahir; Paulsingh, Christian N; Mohamed, Mohamed B; Khan, Safeera (2022).

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which increases risk of overeating. Overconsumption of fat- and sugar-rich meals and beverages have been proposed as a fundamental factor behind the

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falling between 4.0 and 7.5 mg/min are not conclusive and suggest "impaired glucose tolerance," which is an early indication of insulin resistance.

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Russo GL (March 2009). "Dietary n-6 and n-3 polyunsaturated fatty acids: from biochemistry to clinical implications in cardiovascular prevention".

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Elmquist JK, Maratos-Flier E, Saper CB, Flier JS (October 1998). "Unraveling the central nervous system pathways underlying responses to leptin".

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The excessive expansion of adipose tissue that tends to occur under sustainedly positive energy balance (as in overeating) has been postulated by

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having African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American ethnicity

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cells require insulin to absorb glucose and when these cells fail to respond adequately to circulating insulin, blood glucose levels rise. The

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for investigating and quantifying insulin resistance is the "hyperinsulinemic euglycemic clamp," so-called because it measures the amount of

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Sondrup, Nina; Termannsen, Anne-Ditte; Eriksen, Jane N.; Hjorth, Mads F.; Færch, Kristine; Klingenberg, Lars; Quist, Jonas S. (2022-04-01).

5145: 4623: 4568: 3975:"N-3 long chain polyunsaturated fatty acids: a nutritional tool to prevent insulin resistance associated to type 2 diabetes and obesity?" 913:

trial. In epidemiological studies, higher levels of physical activity (more than 90 minutes per day) reduce the risk of diabetes by 28%.

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Maintaining a healthy body weight and engaging in regular physical activity can help mitigate the risk of developing insulin resistance.

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DeFronzo RA, Tobin JD, Andres R (September 1979). "Glucose clamp technique: a method for quantifying insulin secretion and resistance".

1510:"Effects of sleep manipulation on markers of insulin sensitivity: A systematic review and meta-analysis of randomized controlled trials" 803:

20% is infused to maintain blood sugar levels between 5 and 5.5 mmol/L. The rate of glucose infusion is determined by checking the

3387:"Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man" 2922:

Wang G (December 2010). "Singularity analysis of the AKT signaling pathway reveals connections between cancer and metabolic diseases".

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Giannarelli R, Aragona M, Coppelli A, Del Prato S (September 2003). "Reducing insulin resistance with metformin: the evidence today".

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Ioannou GN, Bryson CL, Boyko EJ (2007-11-01). "Prevalence and trends of insulin resistance, impaired fasting glucose, and diabetes".

2283:"The proteomic signature of insulin-resistant human skeletal muscle reveals increased glycolytic and decreased mitochondrial enzymes" 5018: 4668: 641:

to induce lipotoxic and inflammatory effects that may contribute to causing insulin resistance and its accompanying disease states.

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Insufficient sleep has been shown to cause insulin resistance, and also increases the risk of developing metabolic diseases such as

752:"dip," that is a result of an overshoot in insulin production after the failure of the physiologic postprandial insulin response. 4894: 96: 3670:

Kahn R (January 2012). "Reducing the impact of diabetes: is prevention feasible today, or should we aim for better treatment?".

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might play a pivotal role in the pathogenesis of insulin resistance. Mitochondrial dysfunction may result from the formation of

1043: 395:, reduced peripheral utilization of glucose, and increased insulin resistance. It does this by decreasing the translocation of 68: 5253: 3930:

Storlien LH, Baur LA, Kriketos AD, Pan DA, Cooney GJ, Jenkins AB, et al. (June 1996). "Dietary fats and insulin action".

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type 2 was first advanced by Professor Wilhelm Falta and published in Vienna in 1931, and confirmed as contributory by Sir

5269: 4784: 3485:"SPINA Carb: a simple mathematical model supporting fast in-vivo estimation of insulin sensitivity and beta cell function" 1008: 694: 582: 75: 4824: 4751: 2430:"Mitochondrial (Dys)function and Insulin Resistance: From Pathophysiological Molecular Mechanisms to the Impact of Diet" 852: 1409:

Reutrakul S, Van Cauter E (July 2018). "Sleep influences on obesity, insulin resistance, and risk of type 2 diabetes".

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in some patients), alternatives have been sought to simplify the measurement of insulin resistance. The first was the

745: 470: 298: 3436:"Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans" 1821:

Newbern D, Freemark M (December 2011). "Placental hormones and the control of maternal metabolism and fetal growth".

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Himsworth H (1936). "Diabetes mellitus: its differentiation into insulin-sensitive and insulin insensitive types".

734: 674: 202: 581:(hyperinsulinemia) to compensate for the high blood glucose. During this compensated phase of insulin resistance, 54: 39: 4871: 4819: 4716: 1048: 951: 502:, to release insulin into the blood. The insulin makes insulin-sensitive tissues in the body (primarily skeletal 326: 239: 962:

Some scholars go as far as to claim that neither insulin resistance, nor obesity really are metabolic disorders

630:), both of which have the effect of exacerbating peripheral insulin resistance and increasing the likelihood of 562:

and can further worsen insulin resistance. Since insulin is the primary hormonal signal for energy storage into

5054: 4792: 4599: 4442: 2862:"Human resistin is a systemic immune-derived proinflammatory cytokine targeting both leukocytes and adipocytes" 690: 602: 381: 314:

studies, higher levels of physical activity (more than 90 minutes per day) reduce the risk of diabetes by 28%.

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Sergi, D; Naumovski, N; Heilbronn, LK; Abeywardena, M; O'Callaghan, N; Lionetti, L; Luscombe-Marsh, N (2019).

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Schinner S, Scherbaum WA, Bornstein SR, Barthel A (June 2005). "Molecular mechanisms of insulin resistance".

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Dietrich JW, Dasgupta R, Anoop S, Jebasingh F, Kurian ME, Inbakumari M, Boehm BO, Thomas N (October 2022).

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levels to calculate insulin resistance, and all correlate reasonably with the results of clamping studies.

677:(IRS) and PI3K. This concept forms the basis of the adjustable threshold hypothesis of insulin resistance. 234:

There are a number of risk factors for insulin resistance, including being overweight or obese or having a

4859: 4741: 4711: 4701: 4616: 4587: 4531: 719: 353: 217:, various health conditions, and certain medications. Insulin resistance is considered a component of the 2238:

Turner, N; Heilbronn, LK (November 2008). "Is mitochondrial dysfunction a cause of insulin resistance?".

1766:"Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus" 970:(unsafe levels of lipids in the bloodstream and tissues): "Obesity should therefore not be regarded as a 4889: 4884: 4678: 661: 645: 486:

it is estimated that these loci only account for 25–44% of the genetic component of insulin resistance.

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Being exposed to light during sleep has been shown to cause insulin resistance and increase heart rate.

321:, with insulin sensitivity being higher in the morning and lower in the evening. A mismatch between the 3076:"Mechanisms of insulin resistance after insulin-induced hypoglycemia in humans: the role of lipolysis" 2479:

Peraldi P, Spiegelman B (May 1998). "TNF-alpha and insulin resistance: summary and future prospects".

1706:"Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies" 1509: 5140: 5049: 5008: 4941: 4931: 4926: 4814: 4581: 4357:

Reaven GM (2005). "The insulin resistance syndrome: definition and dietary approaches to treatment".

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Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM (February 2002).

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Lucidi P, Rossetti P, Porcellati F, Pampanelli S, Candeloro P, Andreoli AM, et al. (June 2010).

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also makes people three to four times more likely to develop type 2 diabetes and insulin resistance.

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person, normal levels of insulin do not have the same effect in controlling blood glucose levels.

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Hoehn KL, Salmon AB, Hohnen-Behrens C, Turner N, Hoy AJ, Maghzal GJ, et al. (October 2009).

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Other prevailing thoughts that insulin resistance can be an evolutionary adaptation include the

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states that specific risks that may predispose an individual to insulin resistance can include:

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Julve, Josep; Martín-Campos, Jesús M.; Escolà-Gil, Joan Carles; Blanco-Vaca, Francisco (2016).

1888: 1881: 1665:"Protease inhibitor-associated diabetes mellitus: a potential cause of morbidity and mortality" 5300: 5176: 5119: 4829: 4766: 4696: 4651: 4524: 4407: 4374: 4335: 4276: 4227: 4192: 4148: 4099: 3996: 3947: 3904: 3861: 3826: 3777: 3736: 3687: 3652: 3603: 3561: 3542:"Effects of Exercise Modality on Insulin Resistance and Functional Limitation in Older Adults" 3522: 3457: 3408: 3359: 3305: 3270: 3221: 3162: 3105: 3056: 3007: 2947: 2901: 2834: 2799: 2720: 2671: 2628: 2553: 2496: 2461: 2410: 2361: 2304: 2255: 2205: 2170: 2121: 2086: 2037: 1973: 1929: 1892: 1838: 1803: 1735: 1686: 1645: 1637: 1598: 1580: 1539: 1531: 1475: 1426: 1383: 1333: 1276: 1241: 1200: 1157: 1121: 947: 898: 738: 407: 137: 5203: 4804: 4366: 4325: 4315: 4266: 4258: 4219: 4182: 4138: 4130: 4089: 4058: 4023: 3986: 3939: 3896: 3853: 3816: 3808: 3769: 3726: 3718: 3679: 3642: 3634: 3595: 3553: 3512: 3504: 3447: 3398: 3351: 3297: 3260: 3252: 3211: 3201: 3152: 3144: 3095: 3087: 3046: 3038: 2997: 2989: 2939: 2891: 2881: 2826: 2791: 2738: 2710: 2702: 2663: 2620: 2543: 2535: 2488: 2451: 2441: 2400: 2392: 2351: 2343: 2294: 2247: 2197: 2160: 2113: 2076: 2027: 1965: 1921: 1830: 1793: 1785: 1725: 1717: 1676: 1629: 1588: 1570: 1521: 1465: 1457: 1418: 1375: 1367: 1323: 1315: 1268: 1231: 1192: 1149: 1111: 1038: 1018: 920: 823:

Another measure of insulin resistance is the modified insulin suppression test developed by

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Roden M, Price TB, Perseghin G, Petersen KF, Rothman DL, Cline GW, Shulman GI (June 1996).

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Exposure to Artificial Light During Sleep May Increase Risk of Heart Disease and Diabetes

1352: 4311: 3623:"Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin" 3500: 3197: 3140: 2935: 2877: 1781: 4963: 4836: 4330: 4295: 4187: 4170: 4143: 4118: 3821: 3796: 3795:

Keenan MJ, Zhou J, Hegsted M, Pelkman C, Durham HA, Coulon DB, Martin RJ (March 2015).

3731: 3706: 3647: 3622: 3517: 3484: 3265: 3241:"Insulin Units and Conversion Factors: A Story of Truth, Boots, and Faster Half-Truths" 3240: 3216: 3181: 3157: 3124: 3100: 3075: 3051: 3026: 3002: 2977: 2943: 2896: 2861: 2548: 2523: 2456: 2429: 2405: 2380: 2356: 2331: 1798: 1765: 1730: 1705: 1593: 1558: 1470: 1445: 1328: 1303: 1116: 1099: 1028: 627: 543: 377: 345: 294: 283: 279: 170: 162: 4271: 4246: 4245:

Swinburn BA, Nyomba BL, Saad MF, Zurlo F, Raz I, Knowler WC, et al. (July 1991).

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Sedentary lifestyle increases the likelihood of development of insulin resistance. In

5294: 5198: 5189: 4980: 4901: 4879: 4094: 4077: 3797:"Role of resistant starch in improving gut health, adiposity, and insulin resistance" 2779: 2624: 2165: 2148: 1681: 1664: 1272: 1153: 824: 454: 197: 189: 142: 4386: 4035: 3959: 3916: 3873: 3434:

Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, Quon MJ (July 2000).

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Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (July 1985).

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Given the complicated nature of the "clamp" technique (and the potential dangers of

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Acute or chronic inflammation, such as in infections, can cause insulin resistance.

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Studies have consistently shown that there is a link between insulin resistance and

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having health conditions such as high blood pressure and abnormal cholesterol levels

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Multiple studies involving different methodology suggest that impaired function of

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that facilitates the transport of glucose from blood into cells, thereby reducing

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Lovejoy JC (October 2002). "The influence of dietary fat on insulin resistance".

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Burghardt KJ, Seyoum B, Mallisho A, Burghardt PR, Kowluru RA, Yi Z (April 2018).

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In normal metabolism, the elevated blood glucose instructs beta (β) cells in the

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in insulin-sensitive tissues in the body fail to respond normally to the hormone

5028: 4756: 4594: 3773: 1969: 1721: 1617: 890: 804: 796: 730: 665: 442: 4395: 4247:"Insulin resistance associated with lower rates of weight gain in Pima Indians" 3900: 3508: 3355: 3186:

Proceedings of the National Academy of Sciences of the United States of America

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Stenvers DJ, Scheer FA, Schrauwen P, la Fleur SE, Kalsbeek A (February 2019).

1196: 994: 924: 832: 618: 555: 547: 4171:"Diabetes mellitus: a "thrifty" genotype rendered detrimental by "progress"?" 3256: 2446: 1641: 1584: 1535: 680:

Insulin resistance has been proposed to be a reaction to excess nutrition by

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In addition some medications and other health conditions can raise the risk.

5279: 4731: 4466: 4296:"Evolutionary origins of insulin resistance: a behavioral switch hypothesis" 3206: 2830: 1236: 1219: 971: 909: 894: 863:, a measure for insulin sensitivity. All of these calculated markers employ 606: 570: 563: 474: 406:

Based on the significant improvement in insulin sensitivity in humans after

304: 4411: 4378: 4339: 4320: 4231: 4196: 4152: 4103: 4000: 3908: 3865: 3830: 3781: 3740: 3691: 3656: 3607: 3565: 3526: 3461: 3452: 3435: 3363: 3274: 3225: 3166: 3109: 3060: 3042: 3011: 2993: 2951: 2905: 2838: 2803: 2632: 2557: 2465: 2414: 2365: 2308: 2259: 2209: 2174: 2125: 2081: 2064: 2041: 1977: 1933: 1842: 1807: 1739: 1690: 1649: 1602: 1543: 1479: 1430: 1387: 1337: 1245: 1204: 1161: 1125: 4280: 3991: 3974: 3951: 3812: 3412: 2978:"Raison d'être of insulin resistance: the adjustable threshold hypothesis" 2724: 2675: 2500: 2090: 1616:

Schmid, Sebastian M; Hallschmid, Manfred; Schultes, Bernd (January 2015).

1280: 4761: 4547: 3638: 3309: 3125:"Tunable ultrasensitivity: functional decoupling and biological insights" 1575: 1023: 886: 860: 574: 499: 411: 373: 214: 193: 4434: 5227: 4119:"Gluttony, sloth and the metabolic syndrome: a roadmap to lipotoxicity" 4027: 4014:

Falta W, Boller R (1931). "Insulärer und Insulinresistenter Diabetes".

3943: 3403: 3386: 2396: 1789: 1446:"Sleep disorders and the development of insulin resistance and obesity" 935: 871: 867: 864: 800: 788: 769: 765: 515: 507: 388: 206: 185: 166: 53:

if you can. Unsourced or poorly sourced material may be challenged and

4262: 3722: 3148: 3091: 2706: 2147:

Nafiye Y, Sevtap K, Muammer D, Emre O, Senol K, Leyla M (April 2010).

1925: 1319: 908:(DPP) showed that exercise and diet were nearly twice as effective as 477:, disrupting insulin signaling, and reducing the expression of GLUT4. 293:

Diet also has the potential to change the ratio of polyunsaturated to

5163: 5160: 5157: 5154: 5151: 5148: 4644: 4641: 4638: 4635: 4632: 4629: 4489: 2032: 2015: 1993:"Duodenal resurfacing achieves metabolic benefits in type 2 diabetes" 792: 531: 503: 422: 415: 2691:"Mechanism of free fatty acid-induced insulin resistance in humans" 1100:"Fast food, central nervous system insulin resistance, and obesity" 946:

The concept that insulin resistance may be the underlying cause of

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Insulin resistance is strongly associated with intestinal-derived

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Some medications are associated with insulin resistance including

2117: 5013: 3182:"Insulin resistance is a cellular antioxidant defense mechanism" 1710:

Progress in Neuro-Psychopharmacology & Biological Psychiatry

1489:"3 Sleep disorders and their relationship to insulin resistance" 1082:

National Institute of Diabetes and Digestive and Kidney Diseases

631: 434: 247:

National Institute of Diabetes and Digestive and Kidney Diseases

5079: 4520: 473:

is a cytokine that may promote insulin resistance by promoting

2219:"Surprising findings about Hepatitis C and insulin resistance" 975:

defense against further accumulation of lipogenic substrate."

726: 546:

results in reduced uptake of circulating lipids and increased

527: 414:, it has been proposed that some substance is produced in the 18: 2381:"Mitochondrial dysfunction and insulin resistance: an update" 664:. Recent studies suggested that the pathway may operate as a 307:

deficiency has also been associated with insulin resistance.

3344:

American Journal of Physiology. Endocrinology and Metabolism

2860:

Nagaev I, Bokarewa M, Tarkowski A, Smith U (December 2006).

4516: 2524:"Genetics of Insulin Resistance and the Metabolic Syndrome" 2332:"Role of mitochondrial dysfunction in insulin resistance" 1444:

Mesarwi O, Polak J, Jun J, Polotsky VY (September 2013).

1887:(6th ed.). New York: McGraw-Hill Medical. p. 50: 1823:

Current Opinion in Endocrinology, Diabetes and Obesity

372:

Many hormones can induce insulin resistance including

1450:

Endocrinology and Metabolism Clinics of North America

4424: 2069:

The Journal of Clinical Endocrinology and Metabolism

644:

Also, insulin resistance often is associated with a

16:

Failure of cells to respond appropriately to insulin

5262: 5226: 5187: 5118: 5037: 4994: 4870: 4775: 4687: 4554: 4457: 4428: 3027:"Optimal homeostasis necessitates bistable control" 297:phospholipids in cell membranes. The percentage of 136: 131: 3973:Delarue J, LeFoll C, Corporeau C, Lucas D (2004). 1880: 1104:Arteriosclerosis, Thrombosis, and Vascular Biology 577:increase their production of insulin. This causes 3754: 3752: 3750: 3239:Knopp JL, Holder-Pearson L, Chase JG (May 2019). 1380:20.500.11755/fdb8d77a-70e3-4ab7-a041-20b2303b418b 4747:Metabolic Score for Insulin Resistance (METS-IR) 3540:Davidson LE, Hudson R, Kilpatrick K (Jan 2009). 2330:Kim, JA; Wei, Y; Sowers, JR (29 February 2008). 885:The primary treatment for insulin resistance is 673:, which interferes with the interaction between 783:The procedure takes about two hours. Through a 652:) and increased inflammatory cytokine levels. 597:involving elevated triglycerides, small dense 49:Please review the contents of the article and 5091: 4532: 1493:Advanced Cardiovascular Sleep Disorder Center 8: 3337: 3335: 3333: 3331: 3329: 3327: 857:Quantitative insulin sensitivity check index 855:(HOMA), and more recent methods include the 265:having a history of heart disease or stroke. 1218:Chiu KC, Chu A, Go VL, Saad MF (May 2004). 1093: 1091: 5098: 5084: 5076: 4539: 4525: 4517: 4425: 4082:Journal of Gastroenterology and Hepatology 1770:Annals of the New York Academy of Sciences 1224:The American Journal of Clinical Nutrition 282:, low in omega-3 and fiber, and which are 192:(blood sugar). Insulin is released by the 128: 5263:Other pancreatic disorders and conditions 4329: 4319: 4270: 4212:Journal of Diabetes and Its Complications 4186: 4142: 4093: 3990: 3820: 3730: 3646: 3516: 3451: 3402: 3264: 3215: 3205: 3156: 3099: 3050: 3001: 2895: 2885: 2755:(Report). Diabetes Health. Archived from 2714: 2547: 2455: 2445: 2404: 2355: 2298: 2164: 2080: 2031: 1797: 1729: 1680: 1592: 1574: 1525: 1469: 1353:"Circadian clocks and insulin resistance" 1327: 1235: 1115: 1098:Isganaitis E, Lustig RH (December 2005). 795:. In order to compensate for the insulin 768:necessary to compensate for an increased 439:non-alcoholic fatty liver disease (NAFLD) 2379:Montgomery, MK; Turner, N (March 2015). 1958:Surgery for Obesity and Related Diseases 441:are associated with insulin resistance. 262:having a history of gestational diabetes 3031:Journal of the Royal Society, Interface 2982:Journal of the Royal Society, Interface 1622:The Lancet Diabetes & Endocrinology 1060: 993:Modern hypotheses propose that insulin 4123:Trends in Endocrinology and Metabolism 2240:Trends in Endocrinology and Metabolism 1078:"Insulin Resistance & Prediabetes" 410:and rats with surgical removal of the 4371:10.1146/annurev.nutr.24.012003.132155 4251:The Journal of Clinical Investigation 4164: 4162: 2971: 2969: 2917: 2915: 2695:The Journal of Clinical Investigation 609:such as tumor necrosis factor-alpha ( 7: 4789:Metabolic assessment and monitoring 3979:Reproduction, Nutrition, Development 1618:"The metabolic burden of sleep loss" 1072: 1070: 1068: 1066: 1064: 831:Patients initially receive 25 μg of 5065:Notable people with type 1 diabetes 4577:(SIDD, SIRD, MOD and MARD clusters) 3627:The New England Journal of Medicine 2481:Molecular and Cellular Biochemistry 1764:Joseph JJ, Golden SH (March 2017). 329:, may increase insulin resistance. 325:and the meals schedule, such as in 4294:Watve MG, Yajnik CS (April 2007). 4175:American Journal of Human Genetics 4117:Unger RH, Scherer PE (June 2010). 3290:The American Journal of Physiology 2656:The American Journal of Physiology 2522:Brown AE, Walker M (August 2016). 1117:10.1161/01.ATV.0000186208.06964.91 807:levels every five to ten minutes. 791:is infused at 10–120 mU per m per 391:and can lead to increased hepatic 14: 5019:International Diabetes Federation 3889:Experimental Biology and Medicine 3123:Wang G, Zhang M (February 2016). 819:Modified insulin suppression test 756:Hyperinsulinemic euglycemic clamp 624:non-alcoholic fatty liver disease 601:(sdLDL) particles, and decreased 569:In states of insulin resistance, 4895:Hyperosmolar hyperglycemic state 4095:10.1111/j.1440-1746.2010.06473.x 2753:Insulin Resistance Leads to LADA 2625:10.1111/j.1464-5491.2005.01566.x 2225:(Press release). March 10, 2010. 2166:10.1016/j.fertnstert.2008.12.024 1682:10.1097/00126334-200303010-00001 1273:10.2165/00007256-199724050-00004 1154:10.1111/j.1365-2265.2006.02444.x 115: 23: 3302:10.1152/ajpendo.1979.237.3.e214 2668:10.1152/ajpendo.1997.273.4.E708 2016:"Obesity in the new millennium" 1044:Advanced glycation end-products 662:PI3K/Akt/mTOR signaling pathway 205:for insulin resistance include 4224:10.1016/j.jdiacomp.2006.07.005 3558:10.1001/archinternmed.2008.558 729:guidelines. After two hours a 554:. This leads to elevated free 360:Exposure to light during sleep 352:(type of HIV medication), and 51:add the appropriate references 1: 5270:Pancreatic beta cell function 4954:Diabetes-related skin disease 4396:"Insulin resistance syndrome" 4063:10.1016/S0140-6736(01)36134-2 3600:10.1016/s1262-3636(03)72785-2 3546:Archives of Internal Medicine 2348:10.1161/CIRCRESAHA.107.165472 1634:10.1016/s2213-8587(14)70012-9 1423:10.1016/j.metabol.2018.02.010 1360:Nature Reviews. Endocrinology 1009:Pancreatic beta cell function 695:superoxide dismutase mimetics 693:inhibitors, or mitochondrial 4752:Homeostatic model assessment 2944:10.1088/1478-3975/7/4/046015 2887:10.1371/journal.pone.0000031 2202:10.1053/j.gastro.2009.11.050 1835:10.1097/MED.0b013e32834c800d 853:Homeostatic Model Assessment 4737:Noninvasive glucose monitor 3774:10.1016/j.ypmed.2016.10.020 2819:Horm Mol Biol Clin Investig 1970:10.1016/j.soard.2011.03.010 1722:10.1016/j.pnpbp.2018.01.004 1669:J Acquir Immune Defic Syndr 1267:(5). Auckland, NZ: 321–36. 1039:Circadian rhythm disruption 932:polyunsaturated fatty acids 906:Diabetes Prevention Program 746:oral glucose tolerance test 725:Interpretation is based on 299:polyunsaturated fatty acids 36:reliable medical references 5319: 5254:Rabson–Mendenhall syndrome 5247:Congenital hyperinsulinism 4969:Diabetic cheiroarthropathy 4798:Ambulatory glucose profile 4605:Impaired glucose tolerance 4406:(6). US: 1159–63, 1165–6. 4359:Annual Review of Nutrition 3901:10.1177/153537020422900606 3509:10.1038/s41598-022-22531-3 3356:10.1152/ajpendo.00645.2007 2528:Current Cardiology Reports 2014:Friedman JM (April 2000). 1991:Goodman A (June 1, 2016). 1883:Lange Q&A USMLE Step 1 1527:10.1016/j.smrv.2022.101594 735:impaired glucose tolerance 675:insulin receptor substrate 327:circadian rhythm disorders 4717:Postprandial glucose test 4501:. US: NIH. Archived from 4400:American Family Physician 4169:Neel JV (December 1962). 4135:10.1016/j.tem.2010.01.009 4076:Nolan CJ (October 2010). 3858:10.1007/s11892-002-0098-y 3684:10.1377/hlthaff.2011.1075 3588:Diabetes & Metabolism 2796:10.1016/j.cca.2016.02.004 2540:10.1007/s11886-016-0755-4 2300:10.1007/s00125-012-2456-x 2252:10.1016/j.tem.2008.08.001 1462:10.1016/j.ecl.2013.05.001 1372:10.1038/s41574-018-0122-1 1197:10.1016/j.bcp.2008.10.020 1049:Polycystic ovary syndrome 952:Harold Percival Himsworth 878:Prevention and management 714:Glucose tolerance testing 449:Mitochondrial dysfunction 435:Polycystic ovary syndrome 240:polycystic ovary syndrome 42:or relies too heavily on 5055:Epidemiology of diabetes 4793:Blood glucose monitoring 4669:Type 3c (pancreatogenic) 4600:Impaired fasting glucose 4300:BMC Evolutionary Biology 3846:Current Diabetes Reports 3257:10.1177/1932296818805074 2976:Wang G (December 2014). 2447:10.3389/fphys.2019.00532 1663:Fantry LE (March 2003). 1185:Biochemical Pharmacology 923:from high-amylose corn, 691:electron transport chain 632:Type 2 diabetes mellitus 603:high-density lipoprotein 403:) to the cell membrane. 382:human placental lactogen 4912:Neuropathic arthropathy 4016:Klinische Wochenschrift 3440:J Clin Endocrinol Metab 3207:10.1073/pnas.0902380106 3025:Wang G (October 2012). 2831:10.1515/hmbci-2018-0005 2493:10.1023/A:1006865715292 2434:Frontiers in Physiology 2153:Fertility and Sterility 1014:Chronic Somogyi rebound 980:thrifty gene hypothesis 778:glucose clamp technique 671:placental growth factor 599:low-density lipoprotein 459:reactive oxygen species 354:atypical antipsychotics 4860:Gastric bypass surgery 4742:Insulin tolerance test 4712:Glucose tolerance test 4617:Ketosis-prone diabetes 4588:Diabetes and pregnancy 4495:"Insulin resistance". 4321:10.1186/1471-2148-7-61 3453:10.1210/jcem.85.7.6661 3245:J Diabetes Sci Technol 3043:10.1098/rsif.2012.0244 2994:10.1098/rsif.2014.0892 2082:10.1210/jcem.83.5.4779 1995:. Family Practice News 1514:Sleep Medicine Reviews 1142:Clinical Endocrinology 772:level without causing 720:glucose tolerance test 706:Fasting insulin levels 542:Insulin resistance in 253:being aged 45 or older 3813:10.3945/an.114.007419 3801:Advances in Nutrition 2385:Endocrine Connections 2063:Flier JS (May 1998). 1237:10.1093/ajcn/79.5.820 1034:Systemic inflammation 958:Adaptive explanations 646:hypercoagulable state 387:Cortisol counteracts 5050:Glossary of diabetes 5009:Open Insulin Project 4845:Embryonic stem cells 4582:Gestational diabetes 4394:Rao G (March 2001). 3639:10.1056/NEJMoa012512 3552:(2). JAMA: 122–131. 2784:Clinica Chimica Acta 2739:"Insulin resistance" 2336:Circulation Research 1866:USMLE Step 1 Secrets 1576:10.7759/cureus.23501 682:superoxide dismutase 496:Islets of Langerhans 397:glucose transporters 213:, family history of 65:"Insulin resistance" 5060:History of diabetes 5045:Outline of diabetes 4974:Diabetic foot ulcer 4959:Diabetic dermopathy 4918:Organs in diabetes 4850:Artificial pancreas 4810:Diabetes medication 4707:Glycated hemoglobin 4312:2007BMCEE...7...61W 3992:10.1051/rnd:2004033 3594:(4 Pt 2): 6S28–35. 3501:2022NatSR..1217659D 3198:2009PNAS..10617787H 3141:2016NatSR...620345W 2936:2010PhBio...7d6015W 2878:2006PLoSO...1...31N 2578:. December 15, 2012 2106:Nature Neuroscience 1782:2017NYASA1391...20J 656:Molecular mechanism 350:protease inhibitors 236:sedentary lifestyle 211:sedentary lifestyle 161:condition in which 5237:Insulin resistance 5112:glucose metabolism 5024:World Diabetes Day 4612:Insulin resistance 4486:Insulin resistance 4458:External resources 4028:10.1007/BF01736348 3944:10.1007/BF00418533 3404:10.1007/BF00280883 3129:Scientific Reports 2397:10.1530/EC-14-0092 2196:(3): 932–41.e1–3. 1914:Neuroendocrinology 1790:10.1111/nyas.13217 899:thiazolidinediones 776:. It is a type of 583:beta cell function 579:high blood insulin 288:metabolic syndrome 219:metabolic syndrome 151:Insulin resistance 132:Insulin resistance 5288: 5287: 5177:Template:Diabetes 5073: 5072: 4767:Disposition index 4697:Blood sugar level 4567:Type 1 diabetes ( 4481: 4480: 4263:10.1172/JCI115274 3723:10.1136/bmj.i3857 3149:10.1038/srep20345 3092:10.2337/db09-0745 2988:(101): 20140892. 2759:on April 14, 2015 2707:10.1172/JCI118742 2613:Diabetic Medicine 1926:10.1159/000101694 1898:978-0-07-144578-8 1864:Brown DD (2003). 1495:. April 11, 2011. 1320:10.1136/bmj.i3857 948:diabetes mellitus 739:diabetes mellitus 521:insulin-resistant 498:, located in the 408:bariatric surgery 273:Lifestyle factors 148: 147: 126:Medical condition 124: 123: 100: 5308: 5204:Oxyhyperglycemia 5100: 5093: 5086: 5077: 4805:Diet in diabetes 4541: 4534: 4527: 4518: 4513: 4511: 4510: 4426: 4415: 4390: 4344: 4343: 4333: 4323: 4291: 4285: 4284: 4274: 4242: 4236: 4235: 4207: 4201: 4200: 4190: 4166: 4157: 4156: 4146: 4114: 4108: 4107: 4097: 4073: 4067: 4066: 4057:(5864): 127–30. 4046: 4040: 4039: 4011: 4005: 4004: 3994: 3970: 3964: 3963: 3927: 3921: 3920: 3884: 3878: 3877: 3841: 3835: 3834: 3824: 3792: 3786: 3785: 3756: 3745: 3744: 3734: 3702: 3696: 3695: 3667: 3661: 3660: 3650: 3618: 3612: 3611: 3583: 3577: 3576: 3574: 3572: 3537: 3531: 3530: 3520: 3480: 3474: 3473: 3455: 3431: 3425: 3424: 3406: 3382: 3376: 3375: 3339: 3322: 3321: 3285: 3279: 3278: 3268: 3236: 3230: 3229: 3219: 3209: 3192:(42): 17787–92. 3177: 3171: 3170: 3160: 3120: 3114: 3113: 3103: 3071: 3065: 3064: 3054: 3022: 3016: 3015: 3005: 2973: 2964: 2963: 2924:Physical Biology 2919: 2910: 2909: 2899: 2889: 2857: 2851: 2850: 2814: 2808: 2807: 2775: 2769: 2768: 2766: 2764: 2749: 2743: 2742: 2735: 2729: 2728: 2718: 2686: 2680: 2679: 2651: 2645: 2644: 2608: 2602: 2601: 2594: 2588: 2587: 2585: 2583: 2572:"A heavy burden" 2568: 2562: 2561: 2551: 2519: 2513: 2512: 2476: 2470: 2469: 2459: 2449: 2425: 2419: 2418: 2408: 2376: 2370: 2369: 2359: 2327: 2321: 2320: 2302: 2278: 2272: 2271: 2235: 2229: 2226: 2216:Lay summary in: 2213: 2190:Gastroenterology 2185: 2179: 2178: 2168: 2144: 2138: 2137: 2101: 2095: 2094: 2084: 2060: 2054: 2053: 2035: 2033:10.1038/35007504 2011: 2005: 2004: 2002: 2000: 1988: 1982: 1981: 1952: 1946: 1945: 1909: 1903: 1902: 1886: 1879:King MW (2005). 1876: 1870: 1869: 1861: 1855: 1854: 1818: 1812: 1811: 1801: 1761: 1755: 1750: 1744: 1743: 1733: 1701: 1695: 1694: 1684: 1660: 1654: 1653: 1613: 1607: 1606: 1596: 1578: 1554: 1548: 1547: 1529: 1505: 1499: 1496: 1486:Lay summary in: 1483: 1473: 1441: 1435: 1434: 1406: 1400: 1399: 1357: 1348: 1342: 1341: 1331: 1299: 1293: 1292: 1256: 1250: 1249: 1239: 1215: 1209: 1208: 1180: 1174: 1173: 1136: 1130: 1129: 1119: 1095: 1086: 1085: 1074: 1019:Hyperinsulinemia 921:Resistant starch 323:circadian rhythm 319:circadian rhythm 280:glycemic indices 179:hyperinsulinemia 129: 119: 118: 110: 107: 101: 99: 58: 27: 26: 19: 5318: 5317: 5311: 5310: 5309: 5307: 5306: 5305: 5291: 5290: 5289: 5284: 5258: 5242:Hyperinsulinism 5222: 5216:Whipple's triad 5183: 5114: 5106:Disease of the 5104: 5074: 5069: 5033: 5004:T1International 4996: 4995:Advocacy & 4990: 4866: 4815:Insulin therapy 4771: 4683: 4550: 4545: 4508: 4506: 4494: 4482: 4477: 4476: 4453: 4452: 4437: 4423: 4418: 4393: 4356: 4352: 4350:Further reading 4347: 4293: 4292: 4288: 4244: 4243: 4239: 4209: 4208: 4204: 4168: 4167: 4160: 4116: 4115: 4111: 4075: 4074: 4070: 4048: 4047: 4043: 4013: 4012: 4008: 3972: 3971: 3967: 3929: 3928: 3924: 3886: 3885: 3881: 3843: 3842: 3838: 3794: 3793: 3789: 3758: 3757: 3748: 3704: 3703: 3699: 3669: 3668: 3664: 3620: 3619: 3615: 3585: 3584: 3580: 3570: 3568: 3539: 3538: 3534: 3482: 3481: 3477: 3433: 3432: 3428: 3384: 3383: 3379: 3341: 3340: 3325: 3287: 3286: 3282: 3238: 3237: 3233: 3179: 3178: 3174: 3122: 3121: 3117: 3073: 3072: 3068: 3037:(75): 2723–34. 3024: 3023: 3019: 2975: 2974: 2967: 2921: 2920: 2913: 2859: 2858: 2854: 2816: 2815: 2811: 2777: 2776: 2772: 2762: 2760: 2751: 2750: 2746: 2741:. Medicine net. 2737: 2736: 2732: 2701:(12): 2859–65. 2688: 2687: 2683: 2653: 2652: 2648: 2610: 2609: 2605: 2598:"Science daily" 2596: 2595: 2591: 2581: 2579: 2570: 2569: 2565: 2521: 2520: 2516: 2487:(1–2): 169–75. 2478: 2477: 2473: 2427: 2426: 2422: 2378: 2377: 2373: 2329: 2328: 2324: 2280: 2279: 2275: 2237: 2236: 2232: 2217: 2187: 2186: 2182: 2146: 2145: 2141: 2103: 2102: 2098: 2062: 2061: 2057: 2026:(6778): 632–4. 2013: 2012: 2008: 1998: 1996: 1990: 1989: 1985: 1954: 1953: 1949: 1911: 1910: 1906: 1899: 1878: 1877: 1873: 1863: 1862: 1858: 1820: 1819: 1815: 1763: 1762: 1758: 1751: 1747: 1703: 1702: 1698: 1662: 1661: 1657: 1615: 1614: 1610: 1556: 1555: 1551: 1507: 1506: 1502: 1487: 1443: 1442: 1438: 1408: 1407: 1403: 1355: 1350: 1349: 1345: 1301: 1300: 1296: 1261:Sports Medicine 1258: 1257: 1253: 1217: 1216: 1212: 1182: 1181: 1177: 1138: 1137: 1133: 1110:(12): 2451–62. 1097: 1096: 1089: 1076: 1075: 1062: 1058: 1053: 1004: 960: 944: 880: 845: 821: 785:peripheral vein 758: 716: 708: 703: 658: 492: 490:Pathophysiology 483: 467: 451: 432: 393:gluconeogenesis 370: 362: 346:corticosteroids 342: 334:type 2 diabetes 312:epidemiological 275: 232: 227: 196:in response to 177:in response to 127: 120: 116: 111: 105: 102: 59: 48: 44:primary sources 28: 24: 17: 12: 11: 5: 5316: 5315: 5312: 5304: 5303: 5293: 5292: 5286: 5285: 5283: 5282: 5277: 5272: 5266: 5264: 5260: 5259: 5257: 5256: 5251: 5250: 5249: 5239: 5233: 5231: 5224: 5223: 5221: 5220: 5219: 5218: 5208: 5207: 5206: 5195: 5193: 5185: 5184: 5182: 5181: 5180: 5179: 5168: 5167: 5166: 5143: 5138: 5133: 5124: 5122: 5116: 5115: 5105: 5103: 5102: 5095: 5088: 5080: 5071: 5070: 5068: 5067: 5062: 5057: 5052: 5047: 5041: 5039: 5035: 5034: 5032: 5031: 5026: 5021: 5016: 5011: 5006: 5000: 4998: 4992: 4991: 4989: 4988: 4983: 4978: 4977: 4976: 4971: 4966: 4964:Diabetic bulla 4961: 4951: 4950: 4949: 4944: 4939: 4934: 4929: 4924: 4916: 4915: 4914: 4909: 4899: 4898: 4897: 4892: 4887: 4880:Diabetic comas 4876: 4874: 4868: 4867: 4865: 4864: 4863: 4862: 4854: 4853: 4852: 4847: 4839: 4837:Diabetic shoes 4834: 4833: 4832: 4827: 4822: 4812: 4807: 4802: 4801: 4800: 4795: 4787: 4781: 4779: 4773: 4772: 4770: 4769: 4764: 4759: 4754: 4749: 4744: 4739: 4734: 4729: 4724: 4719: 4714: 4709: 4704: 4699: 4693: 4691: 4685: 4684: 4682: 4681: 4676: 4671: 4666: 4665: 4664: 4659: 4649: 4648: 4647: 4620: 4614: 4609: 4608: 4607: 4602: 4592: 4591: 4590: 4578: 4572: 4565: 4564:(SAID cluster) 4558: 4556: 4552: 4551: 4546: 4544: 4543: 4536: 4529: 4521: 4515: 4514: 4492: 4479: 4478: 4475: 4474: 4462: 4461: 4459: 4455: 4454: 4451: 4450: 4438: 4433: 4432: 4430: 4429:Classification 4422: 4421:External links 4419: 4417: 4416: 4391: 4353: 4351: 4348: 4346: 4345: 4286: 4237: 4202: 4158: 4109: 4088:(10): 1594–7. 4068: 4041: 4022:(10): 438–43. 4006: 3965: 3922: 3879: 3836: 3807:(2): 198–205. 3787: 3746: 3697: 3672:Health Affairs 3662: 3633:(6): 393–403. 3613: 3578: 3532: 3475: 3446:(7): 2402–10. 3426: 3377: 3323: 3296:(3): E214-23. 3280: 3251:(3): 597–600. 3231: 3172: 3115: 3086:(6): 1349–57. 3066: 3017: 2965: 2911: 2852: 2809: 2770: 2744: 2730: 2681: 2662:(4): E708-13. 2646: 2603: 2589: 2563: 2514: 2471: 2420: 2371: 2322: 2293:(4): 1114–27. 2273: 2230: 2228: 2227: 2180: 2139: 2096: 2075:(5): 1407–13. 2055: 2006: 1983: 1947: 1904: 1897: 1871: 1856: 1813: 1756: 1745: 1696: 1655: 1608: 1549: 1500: 1498: 1497: 1436: 1401: 1343: 1294: 1251: 1210: 1175: 1131: 1087: 1059: 1057: 1054: 1052: 1051: 1046: 1041: 1036: 1031: 1029:Chronic stress 1026: 1021: 1016: 1011: 1005: 1003: 1000: 959: 956: 943: 940: 930:Some types of 879: 876: 844: 841: 820: 817: 757: 754: 715: 712: 707: 704: 702: 699: 657: 654: 628:glycogenolysis 491: 488: 482: 479: 466: 463: 450: 447: 431: 428: 378:growth hormone 369: 366: 361: 358: 341: 338: 284:hyperpalatable 274: 271: 267: 266: 263: 260: 257: 254: 231: 228: 226: 223: 146: 145: 140: 134: 133: 125: 122: 121: 114: 112: 31: 29: 22: 15: 13: 10: 9: 6: 4: 3: 2: 5314: 5313: 5302: 5299: 5298: 5296: 5281: 5278: 5276: 5273: 5271: 5268: 5267: 5265: 5261: 5255: 5252: 5248: 5245: 5244: 5243: 5240: 5238: 5235: 5234: 5232: 5229: 5225: 5217: 5214: 5213: 5212: 5209: 5205: 5202: 5201: 5200: 5199:Hyperglycemia 5197: 5196: 5194: 5191: 5190:blood glucose 5186: 5178: 5174: 5173: 5172: 5171:Complications 5169: 5165: 5162: 5159: 5156: 5153: 5150: 5147: 5144: 5142: 5139: 5137: 5134: 5132: 5129: 5128: 5126: 5125: 5123: 5121: 5117: 5113: 5109: 5101: 5096: 5094: 5089: 5087: 5082: 5081: 5078: 5066: 5063: 5061: 5058: 5056: 5053: 5051: 5048: 5046: 5043: 5042: 5040: 5036: 5030: 5027: 5025: 5022: 5020: 5017: 5015: 5012: 5010: 5007: 5005: 5002: 5001: 4999: 4997:Organizations 4993: 4987: 4984: 4982: 4981:Hyperglycemia 4979: 4975: 4972: 4970: 4967: 4965: 4962: 4960: 4957: 4956: 4955: 4952: 4948: 4945: 4943: 4940: 4938: 4935: 4933: 4930: 4928: 4925: 4923: 4922:Blood vessels 4920: 4919: 4917: 4913: 4910: 4908: 4905: 4904: 4903: 4902:Diabetic foot 4900: 4896: 4893: 4891: 4888: 4886: 4883: 4882: 4881: 4878: 4877: 4875: 4873: 4872:Complications 4869: 4861: 4858: 4857: 4855: 4851: 4848: 4846: 4843: 4842: 4840: 4838: 4835: 4831: 4828: 4826: 4823: 4821: 4818: 4817: 4816: 4813: 4811: 4808: 4806: 4803: 4799: 4796: 4794: 4791: 4790: 4788: 4786: 4783: 4782: 4780: 4778: 4774: 4768: 4765: 4763: 4760: 4758: 4755: 4753: 4750: 4748: 4745: 4743: 4740: 4738: 4735: 4733: 4730: 4728: 4725: 4723: 4720: 4718: 4715: 4713: 4710: 4708: 4705: 4703: 4700: 4698: 4695: 4694: 4692: 4690: 4686: 4680: 4677: 4675: 4672: 4670: 4667: 4663: 4660: 4658: 4655: 4654: 4653: 4650: 4646: 4643: 4640: 4637: 4634: 4631: 4628: 4627: 4625: 4621: 4618: 4615: 4613: 4610: 4606: 4603: 4601: 4598: 4597: 4596: 4593: 4589: 4586: 4585: 4583: 4579: 4576: 4573: 4570: 4566: 4563: 4560: 4559: 4557: 4553: 4549: 4542: 4537: 4535: 4530: 4528: 4523: 4522: 4519: 4505:on 2015-05-13 4504: 4500: 4499: 4493: 4491: 4487: 4484: 4483: 4473: 4469: 4468: 4464: 4463: 4460: 4456: 4449: 4445: 4444: 4440: 4439: 4436: 4431: 4427: 4420: 4413: 4409: 4405: 4401: 4397: 4392: 4388: 4384: 4380: 4376: 4372: 4368: 4364: 4360: 4355: 4354: 4349: 4341: 4337: 4332: 4327: 4322: 4317: 4313: 4309: 4305: 4301: 4297: 4290: 4287: 4282: 4278: 4273: 4268: 4264: 4260: 4257:(1): 168–73. 4256: 4252: 4248: 4241: 4238: 4233: 4229: 4225: 4221: 4218:(6): 363–70. 4217: 4213: 4206: 4203: 4198: 4194: 4189: 4184: 4181:(4): 353–62. 4180: 4176: 4172: 4165: 4163: 4159: 4154: 4150: 4145: 4140: 4136: 4132: 4129:(6): 345–52. 4128: 4124: 4120: 4113: 4110: 4105: 4101: 4096: 4091: 4087: 4083: 4079: 4072: 4069: 4064: 4060: 4056: 4052: 4045: 4042: 4037: 4033: 4029: 4025: 4021: 4017: 4010: 4007: 4002: 3998: 3993: 3988: 3985:(3): 289–99. 3984: 3980: 3976: 3969: 3966: 3961: 3957: 3953: 3949: 3945: 3941: 3938:(6): 621–31. 3937: 3933: 3926: 3923: 3918: 3914: 3910: 3906: 3902: 3898: 3895:(6): 486–93. 3894: 3890: 3883: 3880: 3875: 3871: 3867: 3863: 3859: 3855: 3852:(5): 435–40. 3851: 3847: 3840: 3837: 3832: 3828: 3823: 3818: 3814: 3810: 3806: 3802: 3798: 3791: 3788: 3783: 3779: 3775: 3771: 3767: 3763: 3755: 3753: 3751: 3747: 3742: 3738: 3733: 3728: 3724: 3720: 3716: 3712: 3708: 3701: 3698: 3693: 3689: 3685: 3681: 3677: 3673: 3666: 3663: 3658: 3654: 3649: 3644: 3640: 3636: 3632: 3628: 3624: 3617: 3614: 3609: 3605: 3601: 3597: 3593: 3589: 3582: 3579: 3567: 3563: 3559: 3555: 3551: 3547: 3543: 3536: 3533: 3528: 3524: 3519: 3514: 3510: 3506: 3502: 3498: 3494: 3490: 3486: 3479: 3476: 3471: 3467: 3463: 3459: 3454: 3449: 3445: 3441: 3437: 3430: 3427: 3422: 3418: 3414: 3410: 3405: 3400: 3396: 3392: 3388: 3381: 3378: 3373: 3369: 3365: 3361: 3357: 3353: 3350:(1): E15-26. 3349: 3345: 3338: 3336: 3334: 3332: 3330: 3328: 3324: 3319: 3315: 3311: 3307: 3303: 3299: 3295: 3291: 3284: 3281: 3276: 3272: 3267: 3262: 3258: 3254: 3250: 3246: 3242: 3235: 3232: 3227: 3223: 3218: 3213: 3208: 3203: 3199: 3195: 3191: 3187: 3183: 3176: 3173: 3168: 3164: 3159: 3154: 3150: 3146: 3142: 3138: 3134: 3130: 3126: 3119: 3116: 3111: 3107: 3102: 3097: 3093: 3089: 3085: 3081: 3077: 3070: 3067: 3062: 3058: 3053: 3048: 3044: 3040: 3036: 3032: 3028: 3021: 3018: 3013: 3009: 3004: 2999: 2995: 2991: 2987: 2983: 2979: 2972: 2970: 2966: 2961: 2957: 2953: 2949: 2945: 2941: 2937: 2933: 2930:(4): 046015. 2929: 2925: 2918: 2916: 2912: 2907: 2903: 2898: 2893: 2888: 2883: 2879: 2875: 2871: 2867: 2863: 2856: 2853: 2848: 2844: 2840: 2836: 2832: 2828: 2824: 2820: 2813: 2810: 2805: 2801: 2797: 2793: 2789: 2785: 2781: 2774: 2771: 2758: 2754: 2748: 2745: 2740: 2734: 2731: 2726: 2722: 2717: 2712: 2708: 2704: 2700: 2696: 2692: 2685: 2682: 2677: 2673: 2669: 2665: 2661: 2657: 2650: 2647: 2642: 2638: 2634: 2630: 2626: 2622: 2619:(6): 674–82. 2618: 2614: 2607: 2604: 2599: 2593: 2590: 2577: 2576:The Economist 2573: 2567: 2564: 2559: 2555: 2550: 2545: 2541: 2537: 2533: 2529: 2525: 2518: 2515: 2510: 2506: 2502: 2498: 2494: 2490: 2486: 2482: 2475: 2472: 2467: 2463: 2458: 2453: 2448: 2443: 2439: 2435: 2431: 2424: 2421: 2416: 2412: 2407: 2402: 2398: 2394: 2391:(1): R1–R15. 2390: 2386: 2382: 2375: 2372: 2367: 2363: 2358: 2353: 2349: 2345: 2342:(4): 401–14. 2341: 2337: 2333: 2326: 2323: 2318: 2314: 2310: 2306: 2301: 2296: 2292: 2288: 2284: 2277: 2274: 2269: 2265: 2261: 2257: 2253: 2249: 2246:(9): 324–30. 2245: 2241: 2234: 2231: 2224: 2223:Science Daily 2220: 2215: 2214: 2211: 2207: 2203: 2199: 2195: 2191: 2184: 2181: 2176: 2172: 2167: 2162: 2159:(6): 1864–9. 2158: 2154: 2150: 2143: 2140: 2135: 2131: 2127: 2123: 2119: 2115: 2112:(6): 445–50. 2111: 2107: 2100: 2097: 2092: 2088: 2083: 2078: 2074: 2070: 2066: 2059: 2056: 2051: 2047: 2043: 2039: 2034: 2029: 2025: 2021: 2017: 2010: 2007: 1994: 1987: 1984: 1979: 1975: 1971: 1967: 1964:(2): 145–50. 1963: 1959: 1951: 1948: 1943: 1939: 1935: 1931: 1927: 1923: 1919: 1915: 1908: 1905: 1900: 1894: 1890: 1885: 1884: 1875: 1872: 1868:. p. 63. 1867: 1860: 1857: 1852: 1848: 1844: 1840: 1836: 1832: 1829:(6): 409–16. 1828: 1824: 1817: 1814: 1809: 1805: 1800: 1795: 1791: 1787: 1783: 1779: 1775: 1771: 1767: 1760: 1757: 1754: 1749: 1746: 1741: 1737: 1732: 1727: 1723: 1719: 1715: 1711: 1707: 1700: 1697: 1692: 1688: 1683: 1678: 1674: 1670: 1666: 1659: 1656: 1651: 1647: 1643: 1639: 1635: 1631: 1627: 1623: 1619: 1612: 1609: 1604: 1600: 1595: 1590: 1586: 1582: 1577: 1572: 1569:(3): e23501. 1568: 1564: 1560: 1553: 1550: 1545: 1541: 1537: 1533: 1528: 1523: 1519: 1515: 1511: 1504: 1501: 1494: 1490: 1485: 1484: 1481: 1477: 1472: 1467: 1463: 1459: 1456:(3): 617–34. 1455: 1451: 1447: 1440: 1437: 1432: 1428: 1424: 1420: 1416: 1412: 1405: 1402: 1397: 1393: 1389: 1385: 1381: 1377: 1373: 1369: 1365: 1361: 1354: 1347: 1344: 1339: 1335: 1330: 1325: 1321: 1317: 1313: 1309: 1305: 1298: 1295: 1290: 1286: 1282: 1278: 1274: 1270: 1266: 1262: 1255: 1252: 1247: 1243: 1238: 1233: 1229: 1225: 1221: 1214: 1211: 1206: 1202: 1198: 1194: 1191:(6): 937–46. 1190: 1186: 1179: 1176: 1171: 1167: 1163: 1159: 1155: 1151: 1148:(2): 169–78. 1147: 1143: 1135: 1132: 1127: 1123: 1118: 1113: 1109: 1105: 1101: 1094: 1092: 1088: 1083: 1079: 1073: 1071: 1069: 1067: 1065: 1061: 1055: 1050: 1047: 1045: 1042: 1040: 1037: 1035: 1032: 1030: 1027: 1025: 1022: 1020: 1017: 1015: 1012: 1010: 1007: 1006: 1001: 999: 996: 991: 987: 983: 981: 976: 973: 969: 965: 957: 955: 953: 949: 941: 939: 937: 933: 928: 926: 922: 918: 914: 911: 907: 902: 900: 896: 892: 888: 883: 877: 875: 873: 869: 866: 862: 859:(QUICKI) and 858: 854: 850: 842: 840: 838: 834: 829: 826: 825:Gerald Reaven 818: 816: 812: 808: 806: 802: 798: 794: 790: 786: 781: 779: 775: 771: 767: 763: 762:gold standard 755: 753: 751: 747: 742: 740: 736: 732: 728: 723: 721: 713: 711: 705: 700: 698: 696: 692: 687: 683: 678: 676: 672: 667: 663: 655: 653: 651: 647: 642: 640: 635: 633: 629: 625: 620: 616: 612: 608: 604: 600: 596: 592: 587: 584: 580: 576: 572: 567: 565: 561: 557: 553: 552:triglycerides 549: 545: 540: 537: 533: 529: 524: 522: 517: 513: 509: 505: 501: 497: 489: 487: 480: 478: 476: 472: 464: 462: 460: 456: 448: 446: 444: 440: 436: 429: 427: 424: 420: 419:speculative. 417: 413: 409: 404: 402: 398: 394: 390: 385: 383: 379: 375: 367: 365: 359: 357: 355: 351: 347: 339: 337: 336:and obesity. 335: 330: 328: 324: 320: 315: 313: 308: 306: 302: 300: 296: 291: 289: 285: 281: 272: 270: 264: 261: 258: 255: 252: 251: 250: 248: 243: 241: 237: 229: 224: 222: 220: 216: 212: 208: 204: 199: 198:carbohydrates 195: 191: 190:blood glucose 187: 184:Insulin is a 182: 180: 176: 172: 168: 164: 160: 156: 152: 144: 143:Endocrinology 141: 139: 135: 130: 113: 109: 98: 95: 91: 88: 84: 81: 77: 74: 70: 67: – 66: 62: 61:Find sources: 56: 52: 46: 45: 41: 37: 32:This article 30: 21: 20: 5236: 5211:Hypoglycemia 4986:Hypoglycemia 4890:Ketoacidosis 4885:Hypoglycemia 4825:conventional 4727:Glucose test 4722:Fructosamine 4611: 4507:. 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Jun 2009. 1084:. May 2018. 891:weight loss 805:blood sugar 556:fatty acids 443:Hepatitis C 340:Medications 34:needs more 5275:Insulinoma 4785:Prevention 4777:Management 4702:Biomarkers 4509:2013-04-25 4402:(review). 4361:(review). 4051:The Lancet 2872:(1): e31. 2582:10 January 1520:: 101594. 1411:Metabolism 1056:References 995:metabolism 925:amylomaize 833:octreotide 648:(impaired 639:Vidal-Puig 619:NF-kappa-B 571:beta cells 550:of stored 548:hydrolysis 290:epidemic. 76:newspapers 5280:Insulitis 5230:disorders 5188:Abnormal 4830:pulsatile 4820:intensive 4732:C-peptide 4662:Permanent 4657:Transient 4622:Type 3a ( 4467:eMedicine 4306:(1): 61. 3717:: i3857. 3135:: 20345. 2534:(8): 75. 1716:: 55–63. 1642:2213-8587 1585:2168-8184 1536:1087-0792 1417:: 56–66. 1314:: i3857. 972:pathology 910:metformin 895:metformin 718:During a 701:Diagnosis 607:cytokines 564:fat cells 544:fat cells 514:) absorb 475:lipolysis 305:Vitamin D 295:saturated 245:The U.S. 175:receptors 138:Specialty 5301:Diabetes 5295:Category 5120:Diabetes 5108:pancreas 4762:SPINA-GR 4652:Neonatal 4580:Type 4 ( 4571:cluster) 4548:Diabetes 4498:Diabetes 4472:med/1173 4412:11277552 4387:24849146 4379:16011472 4340:17437648 4232:17967708 4197:13937884 4153:20223680 4104:20880166 4036:32359074 4001:15460168 3960:33171616 3917:20966659 3909:15169967 3874:31329463 3866:12643169 3831:25770258 3782:27773709 3762:Prev Med 3741:27510511 3692:22232097 3657:11832527 3608:14502098 3566:19171808 3527:36271244 3462:10902785 3421:24872571 3364:17957034 3275:30318910 3226:19805130 3167:26847155 3110:20299466 3080:Diabetes 3061:22535698 3012:25320065 2960:40064689 2952:21178243 2906:17183659 2866:PLOS ONE 2839:29596053 2804:26868089 2641:10680747 2633:15910615 2558:27312935 2509:32740002 2466:31130874 2415:25385852 2366:18309108 2309:22282162 2268:22469532 2260:18804383 2210:19962985 2175:19171332 2126:10196541 2042:10766249 1999:12 March 1978:21570362 1942:38081413 1934:17426391 1851:24095227 1843:21986512 1808:27750377 1740:29325867 1691:12626882 1650:24731536 1603:35494895 1544:35189549 1480:24011890 1431:29510179 1396:54449238 1388:30531917 1338:27510511 1289:29053249 1246:15113720 1205:19022225 1170:22878943 1162:16430716 1126:16166564 1024:Resistin 1002:See also 887:exercise 861:SPINA-GR 797:infusion 731:glycemia 684:in cell 666:bistable 575:pancreas 500:pancreas 481:Genetics 430:Diseases 412:duodenum 374:cortisol 368:Hormones 215:diabetes 194:pancreas 173:insulin 5228:Insulin 4448:D007333 4331:1868084 4308:Bibcode 4281:2056116 4188:1932342 4144:2880185 3952:8781757 3822:4352178 3732:4979358 3648:1370926 3518:9587026 3497:Bibcode 3489:Sci Rep 3470:7612943 3413:3899825 3318:7192984 3266:6501531 3217:2764908 3194:Bibcode 3158:4742884 3137:Bibcode 3101:2874695 3052:3427521 3003:4223910 2932:Bibcode 2897:1762367 2874:Bibcode 2847:4515780 2763:Feb 21, 2725:8675698 2676:9357799 2549:4911377 2501:9609126 2457:6510277 2440:: 532. 2406:4261703 2357:2963150 2317:5843657 2134:7474447 2091:9589630 2050:4406498 1799:5334212 1778:Bibcode 1731:5817633 1594:9036496 1471:3767932 1329:4979358 1281:9368278 942:History 936:omega-3 893:. 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