This abnormality is essential for the pathogenesis of type 2 diabetes, and further turns into an independent risk factor in cardiovascular disease. Insulin resistance originates in a cluster of conditions which may be genetic -so far unknown-, and environmental, such as
obesity, a sedentary lifestyle, and stress.
Besides, insulin resistance makes peripheral tissues (muscles, fat) significantly reduce their uptake of glucose, while leading the liver to produce glucose in excess. It is now known that insulin resistance is present in early (prehyperglycemic) stages of type 2 diabetes, in which patients present with compensating hyperinsulinemia.
Eventually, this compensation mechanism becomes less efficient, so that type 2 diabetes results. The disorders in the sensitivity and in the secretion of insulin worsen due to metabolic factors. Chronic hyperglycemia has “toxic” effects on many bodily cells, including β pancreatic cells, and skeletal muscle fibers (glycotoxicity). At the same time, the increase in lipolysis (the breakdown of storage triglycerides) results in an exaggerated release of free fatty acids that act by reducing the amount glucose that is taken up and consumed by muscle cells.
de la insulina circulante en la sangre. Esta alteración es fundamental para la patogénesis de la diabetes tipo 2. Además, constituye un factor de riesgo independiente para el desarrollo de la enfermedad cardiovascular.
La RI reconoce un origen multifactorial, donde intervienen factores genéticos –por ahora desconocidos- y ambientales como ser la obesidad, el sedentarismo y el estrés. La RI disminuye en forma marcada la captación de glucosa por parte de los tejidos periféricos (músculo, tejido adiposo), lo cual conlleva a una producción exagerada de glucosa por parte del hígado.
Actualmente, se sabe que la RI se encuentra presente en etapas
precoces (prehiperglucémicas) de la diabetes tipo 2, en las cuales los pacientes presentan una hiperinsulinemia compensadora. Con el tiempo este mecanismo de compensación pierde efectividad, manifestándose entonces la diabetes tipo 2. Los trastornos en la sensibilidad
y la secreción de insulina se ven agravados por factores metabólicos. La hiperglucemia crónica tiene efectos “tóxicos” sobre muchas células del organismo, que incluyen a las células β del páncreas y las fibras musculares estriadas (glucotoxicidad).
Paralelamente, el incremento de la lipólisis (donde los lípidos del organismo son metabolizados) genera una liberación exagerada de ácidos grasos libres, que actúan disminuyendo de la entrada de glucosa y su consumo por las células musculares.
Actos generic name: pioglitazone class: thiazolidinediones
Amaryl generic name: glimepiride class: sulfonylureas
Bydureon generic name: exenatide class: incretin mimetics
Byetta generic name: exenatide class: incretin mimetics
Farxiga generic name: dapagliflozin class: SGLT-2 inhibitors
Glucophage generic name: metformin class: non-sulfonylureas
Glucotrol generic name: glipizide class: sulfonylureas
Humalog generic name: insulin lispro class: insulin
Invokana generic name: canagliflozin class: SGLT-2 inhibitors
Janumet generic name: metformin/sitagliptin class: antidiabetic combinations
Januvia generic name: sitagliptin class: dipeptidyl peptidase 4 inhibitors
Kombiglyze XR generic name: metformin/saxagliptin class: antidiabetic combinations
Lantus generic name: insulin glargine class: insulin
Lantus Solostar generic name: insulin glargine class: insulin
Levemir generic name: insulin detemir class: insulin
Novolog generic name: insulin aspart class: insulin
Onglyza generic name: saxagliptin class: dipeptidyl peptidase 4 inhibitors
Tradjenta generic name: linagliptin class: dipeptidyl peptidase 4 inhibitors
Victoza generic name: liraglutide class: incretin mimetics
Welchol generic name: colesevelam class: bile acid sequestrants
Drugs associated with Diabetes, Type 1
Apidra generic name: insulin glulisine class: insulin
Exubera (Pro, More…)
generic name: insulin inhalation, rapid acting class: insulin
Humalog generic name: insulin lispro class: insulin
Humalog KwikPen generic name: insulin lispro class: insulin
Humalog Mix 75 / 25 generic name: insulin lispro/insulin lispro protamine class: insulin
Humulin 70 / 30 generic name: insulin isophane/insulin regular class: insulin
Humulin N generic name: insulin isophane class: insulin
Humulin R generic name: insulin regular class: insulin
Lantus generic name: insulin glargine class: insulin
Lantus Solostar generic name: insulin glargine class: insulin
Levemir generic name: insulin detemir class: insulin
Novolin 70 / 30 generic name: insulin isophane/insulin regular class: insulin
Novolin N generic name: insulin isophane class: insulin
Novolin R generic name: insulin regular class: insulin
Novolog generic name: insulin aspart class: insulin
NovoLog FlexPen generic name: insulin aspart class: insulin
NovoLog Mix 70 / 30 generic name: insulin aspart/insulin aspart protamine class: insulin
NovoLog Mix 70 / 30 FlexPen generic name: insulin aspart/insulin aspart protamine class: insulin
Symlin generic name: pramlintide class: amylin analogs
Victoza generic name: liraglutide class: incretin mimetics
