| Topic: | Diabetes (DM) |
| Title: | Insulin Resistance and Hyperinsulinemia: Recognizing the Risk and Reversing the Process. |
| Author: | Wangerin-Lile, D.; Goar, S.L. |
| Source: | Physician Assistant. 24(9): 23-24, 26, 29-30, 33-36, 38-39. September 2000. |
| Availability: | Available from Springhouse Corporation. Physician Assistant, P.O. Box 908, Springhouse, PA 19477. (215) 646-8700. Fax (215) 646-4399. |
| Abstract: | This article reviews the pathophysiology, risk factors, and dietary therapy for hyperinsulinemia (HI) and discusses the link between HI and vascular disease. Insulin resistance (IR) with concomitant HI is a significant risk factor for the development of type 2 diabetes and coronary heart disease. A person develops IR/HI when the insulin response to nutrients becomes chronically elevated. IR/HI is caused by a complexity of genetic and environmental influences. Early identification is important because of the microvascular and macrovascular damage the body experiences prior to the onset of hyperglycemia. Understanding the pathophysiology of IR/HI, the metabolism of nutrients, and the optimal therapeutic diet can help clinicians reverse the primary metabolic disturbance and prevent progression to diabetes, heart disease, and end organ damage. Nutritional therapy should be initiated prior to or in conjunction with pharmacotherapy. Based on physiologic, epidemiologic, and clinical evidence, the low fat, high carbohydrate diet is not appropriate for the IR/HI patient. The most appropriate diet for people who have IR/HI is adequate protein, moderate complex carbohydrate, minimal refined carbohydrate, and healthy fats. Micronutrients are also important in optimizing the health of a patient who has IR/HI. Exercise is also an important key to insulin sensitivity; therefore, exercise, together with a low to no starch diet will cause a dramatic increase in fat utilization for energy. Although diet therapy is needed to reverse the metabolic disturbance associated with IR/HI, pharmacotherapies may be needed to treat the associated risk factors that often accompany IR/HI. 2 figures. 6 tables. 60 references. (AA-M). |
| Format: | Journal Article |
| Language: | English. |
| Major Keywords: | Diabetes Mellitus. Type 2 Diabetes. Hyperinsulinism. Insulin Resistance. Risk Factors. Pathophysiology. Diet Therapy. Exercise. Drug Therapy. |
| Minor Keywords: | Genetics. Environmental Factors. Cardiovascular Diseases. Hyperglycemia. Dietary Fats. Carbohydrates. Protein. Dietary Fiber. Vitamins. |
| Publication Number: | DMJA09370 |
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