Insulin resistance and insulin sensitizing agents

Area of Science:

• Metabolic disorders
• Endocrinology
• Molecular biology

Background:

• Insulin resistance is common in obesity and type 2 diabetes, but subtypes like severe insulin resistant diabetes (SIRD) show distinct metabolic abnormalities and higher comorbidity risks.
• Insulin resistance involves adipose tissue dysfunction, lipotoxicity, glucotoxicity, oxidative stress, and inflammation.
• Exosomes carrying proteins, mRNA, and microRNA mediate altered crosstalk between tissues in insulin resistance.

Purpose of the Study:

• To review the molecular mechanisms underlying insulin resistance.
• To explore the role of exosomes and microRNAs in insulin resistance.
• To summarize current and novel strategies for managing insulin resistance in humans.

Main Methods:

• Literature review of molecular mechanisms.
• Analysis of signaling pathways involving metabolites and exosomes.
• Summary of therapeutic interventions for insulin resistance.

Main Results:

• Severe insulin resistant diabetes (SIRD) is associated with significant metabolic dysfunction and increased risk of cardiovascular, renal, and hepatic comorbidities.
• Exosomes and their cargo (proteins, mRNA, microRNA) play a role in the altered intercellular communication contributing to insulin resistance.
• Reduction in fat mass through lifestyle changes or bariatric surgery improves insulin sensitivity.

Conclusions:

• Insulin resistance is a complex condition with diverse molecular underpinnings, including exosome-mediated crosstalk.
• Effective management strategies involve lifestyle modifications, weight reduction, and pharmacological interventions targeting various pathways.
• Further research into molecular mechanisms and therapeutic targets is essential for combating insulin resistance and its complications.