Lg Cwd
icon-nav-help
Need Help

Submit your question to our team of health care professionals.

icon-nav-current-questions
Current Question

See what's on the mind of the community right now.

icon-conf-speakers-at-a-glance
Meet the Team

Learn more about our world-renowned team.

icon-nav-archives
DTeam Archives

Review the entire archive according to the date it was posted.

icon-question-mark
September 15, 2007

Type 2

Question from India:

Can we consider insulin resistance as a tolerance or resistance to previous excessive or increased exposure of sugar or/and insulin in type 2 diabetics? Is such previous excessive or more exposure common up to some stages after getting type 2 diabetes? As such, can decreasing excessive intake of foods, exercising, withdrawal of oral diabetic medicines and injected insulin for some time can help in reversing insulin resistance? I mean reversing insulin resistance, but not just normalizing of glucose level temporarily.

Answer:

Resistance can happen both ways. For instance, patients with type 1 diabetes are insulin resistant. They are exposed to high insulin levels with exogenous insulin therapy. This results in down-regulation of insulin receptors. We routinely clamp patients with good control with type 1 diabetes and they have insulin resistance, compared to age-matched healthy subjects. People with type 2 diabetes have insulin resistance as a result of a post-receptor defect in insulin signal transduction. It is clear that short-term food restriction or weight loss will decrease insulin resistance. However, there is no eliminating insulin resistance as a pathophysiologic process. The property is genetic and can be seen in first degree relatives of people with type 2 diabetes who are otherwise healthy. It can be decreased with healthy lifestyle.

JTL