Insulin resistance – the basics every medical specialist should know

Gołacki Jakub, Matuszek Małgorzata, Jarosz Piotr. Insulin resistance – the basics every medical specialist should know. Journal of Education, Health and Sport. 2022;12(7):179-184. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2022.12.07.017 https://apcz.umk.pl/JEHS/article/view/JEHS.2022.12.07.017 https://zenodo.org/record/6578664 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2022; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 04.05.2022. Revised: 15.05.2022. Accepted: 25.05.2022. Insulin resistance – the basics every medical specialist should know Jakub Gołacki jakub.golacki@gmail.com, https://orcid.org/0000-0001-8502-3030 Samodzielny Publiczny Szpital Kliniczny nr 4 w Lublinie Małgorzata Matuszek gosiamatuszek15@gmail.com, https://orcid.org/0000-0001-5691-6032 Uniwersytet Medyczny w Lublinie Piotr Jarosz pjarosz196@gmail.com, https://orcid.org/0000-0003-0489-2600 Uniwersytet Medyczny w Lublinie Abstract Introduction and purpose: Insulin resistance (IR) is a health problem as it can accompany obesity and lead to serious metabolic complications. In recent years, it has been "overdiagnosed" in clinical practice due to the lack of specific diagnostic criteria. The article summarizes the current knowledge in the field of pathophysiology, clinical picture and diagnostics. State of knowledge: Obesity remains the leading cause of IR, especially in the 21st century. In a positive energy balance, the adipocyte overloaded with fat protects itself against further influx of glucose and fats and becomes insulin insensitive. A component of IR development is subclinical inflammation of macrophage-rich adipose tissue which is exacerbated by an adipocytokine imbalance, which in turn generates IR. The markers of cellular resistance to insulin are free fatty acids in the bloodstream which are responsible for the lipotoxicity in hepatocytes and myocytes. Compensatory fasting hyperinsulinemia, which is currently considered the most sensitive diagnostic criterion, provides evidence of IR. An effective method of sensitizing cells to insulin is lifestyle modification, including a low-energy diet with regular physical activity in the form of aerobic-resistance exercise. Literature recommends no pharmacological treatment of IR alone, without obesity or other concomitant diseases. Conclusions: IR is not a separate disease, but only a pathological expression of cells' adaptation to excess of consumed energy. However, in its systemic form, when the protective mechanisms become ineffective, it induces metabolic disturbances. Only the causal treatment of IR guarantees therapeutic success. Key words: insulin resistance;hyperinsulinemia; obesit