Insulinooporność w chorobach endokrynnych — sposoby terapii

Abstract

Changes in sensitivity to insulin occur in the course of a number of endocrine disorders. Most of the hormones through their antagonistic action to insulin lead to increased hepatic glucose output and its decreased utilisation in peripheral tissues. Carbohydrate disorders observed in endocrine diseases result from the phenomenon of insulin resistance, and in some cases also a reduction in insulin secretion is present. Abnormalities of glucose metabolism are observed in acromegaly, but also in growth hormone deficiency, hypercortisolism in the course of Cushing's syndrome, hyper- or hypothyroidism, primary hyperparathyroidism, aldosteronism, pheochromocytoma, congenital hypertrophy of the adrenal glands, polycystic ovaries syndrome, hypogonadism, or other hormonally active neuroendocrine tumours. They are of a secondary nature in relation to impaired hormonal balance. Hyperglycaemia is therefore often reversible, and the most effective method of treatment of impaired insulin sensitivity is successful therapy of specific endocrinopathies. Insulin sensitisers, also with a good effect, are used. Most experiences to date can be attributed to metformin therapy. Attempts have been made at treatment with other agents that are also effective in reducing insulin resistance as incretins or glitazones. In the presented paper, the authors reviewed endocrine diseases in which there is a clinically significant change in insulin sensitivity. Moreover, methods of therapy of concomitant disturbed glucose metabolism were presented.

The effect of short-term perindopril and telmisartan treatment on circulating levels of anti-inflammatory cytokines in hypertensive patients

“…In the light of obtained results, it seems reasonable to assume that a more beneficial effect of telmisartan than of perindopril on IL-10 levels may be, at least in part, attributed to differences in the impact of both drugs on insulin sensitivity. Apart from its angiotensin receptor blocker activity, telmisartan was shown to act as a partial agonist for peroxisome proliferator-activated receptor-γ, which is implicated in the regulation of energy homeostasis [28,29]. In our study, IL-10 was the only cytokine, the levels of which correlated with HOMA1-IR.…”

Klotho protein function among patients with type 1 diabetes

“…Zbyt późno postawiona diagnoza i brak kontroli choroby prowadzą do rozwoju przewlekłych powikłań, które powodują niepełnosprawność, niezdolność do pracy oraz zwiększają przedwczesną śmiertelność [4][5][6]. Wśród tradycyjnych czynników ryzyka rozwoju przewlekłych powikłań kluczową rolę odgrywają hiperglikemia [7] oraz insulinooporność (IR, insulin resistance) [8], obejmująca zmniejszoną wrażliwość mięśni, tkanki tłuszczowej oraz wątroby na działanie insuliny [9]. Dodatkowymi czynnikami ryzyka są dyslipidemia [10], nadciśnienie tętnicze (NT) [11], palenie papierosów [12] oraz przewlekły stan zapalny [7].…”

“…Late diagnosis and uncontrolled disease leads to the development of long-term complications that cause disability, inability to work, and increased premature mortality [4][5][6]. Among the traditional risk factors of chronic complications, a crucial role is played by hyperglycaemia [7] and insulin resistance [8], which includes decreased muscle, fat, and liver sensitivity to insulin [9]. Additional risk factors are dyslipidaemia [10], arterial hypertension [11], cigarette smoking [12], and inflammation [7].…”

Basic anthropometric measurements and derived indicators in dietary counseling: Part two

“…Zaburzona gospodarka hormonalna może oddziaływać na występowanie insulinooporności. 13 Hormony potencjalnie oddziałujące na na rozwój cukrzycy to: hormon wzrostu (ang. growth hormone -GH), glikokortykosteroidy, tyroksyna, katecholaminy, aldosteron, parathormon, glukagon oraz somatostatyna.…”