1型糖尿病中的胰岛素抵抗:病理生理学,临床和治疗相关性
Maria Apostolopoulou1,2,3, Vaia Lambadiari4, Michael Roden1,2,3
1Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, 40225 Düsseldorf, Germany.
Endocrine reviews
|February 25, 2025
概括
患有1型糖尿病 (T1D) 的人经常经历胰岛素抵抗,而不仅仅是β细胞衰竭. 本综述探讨了T1D胰岛素抵抗机制,临床特征和治疗目标,以更好地控制葡萄糖.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 免疫学 免疫学 免疫学
背景情况:
- 1型糖尿病 (T1D) 通常以β细胞衰竭为特征.
- 然而,胰岛素抵抗在T1D患者中经常存在.
- 自身免疫和代谢因素之间的相互作用有助于T1D病理生理学.
研究的目的:
- 审查T1D中胰岛素抵抗的机制,临床特征和治疗相关性.
- 为了突出T1D与2型糖尿病相比,胰岛素抵抗的独特表型.
- 讨论胰岛素治疗和其他因素在T1D胰岛素抵抗中的作用.
主要方法:
- 专注于使用黄金标准技术的人体研究,主要是euglycemic-hyperinsulinemic.
- 分析涉及代谢和自身免疫因素的病理生理学.
- 对T1D中组织特异性胰岛素抵抗的临床特征和进展的审查.
主要成果:
- 在T1D中,胰岛素耐药性可能是组织特异性的,在早期发展并持久.
- 病理生理学是复杂的,涉及到协同的代谢和自身免疫因素.
- 胰岛素治疗,生活方式因素和葡萄糖脂毒性有助于胰岛素抵抗,但可能不能完全解释T1D表型.
结论:
- 胰岛素抵抗是T1D的一个重要,可治疗的组成部分.
- 与每天多次注射相比,持续的皮下胰岛素输注可能会改善胰岛素耐药性.
- 新兴疗法在改善T1D的胰岛素抵抗方面表现有前途,但成本和非标签性使用限制了目前的应用.
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