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Medical Forum / Diseases and Disorders / Diabetes / March 2008

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Insulin oscillations & Insulin resistance?

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Kumar - 22 Mar 2008 09:45 GMT
Hello,

Insulin's exposure to target cells in diabetic type2 can be continual
& increased either due to natural reasons by irregular eating habit,
modern lifestyle & stress OR as a result of medication programme.
Howver instabilties in natural Insulin oscillations can also be linked
to insulin resistance as per following quote:-

"Insulin oscillations

Insulin release from pancreas is pulsatile with a period of 3-6
minutes. [1]The insulin concentration in blood increases after meals
and gradually returns to basal levels during 1-2 hours. However, the
basal insulin level is not stable. It oscillates with a regular period
of 3-6 min. After a meal the amplitude of these oscillations increases
but the periodicity remains constant. [1] The oscillations are
believed to be important for insulin sensitivity by preventing
downregulation of insulin receptors in target cells. [1] Such down
regulation underlies insulin resistance, which is common in type 2
diabetes. It would therefore be advantageous to administer insulin to
diabetic patients in a manner mimicking the natural oscillations. [..
Disturbances of the insulin oscillations occur early in diabetes and
may contribute to insulin resistance.
http://en.wikipedia.org/wiki/Insulin_release_oscillations "

Under such consideration, how this aspect alongwith increased
insulin's exposure resulting downregulation of insulin's receptors,
which can be common in type2 diabetics, address insulin resistance?

Best wishes.
Kofi - 24 Mar 2008 10:35 GMT
I think you're asking what you do to keep IRS-1 and/or IRS-2 from
downregulating.  There's an extensive literature for this.  I don't
regularly follow it but this is what's in my notes.  I suspect
intermittent fasting will also improve insulin sensitivity via IRS-1/2
but I haven't checked.

green tea increase insulin-stimulated glucose uptake and insulin binding
to adipocytes; EGCG mimics insulin by stimulating tyrosine
phosphorylation of the insulin receptor and IRS-1 and increases
phosphoinositide 3-kinase (PI3K), MAPK and p70, EGCG also inhibits
glucose production in the liver, possibly by repressing genes for
gluconeogenesis <http://www.jbc.org/cgi/content/full/277/38/24933>

in obese rats, exercise training along with alpha lipoic acid improves
the skeletal muscle levels of IRS-1 (insulin receptor substrate-1),
glucose transport along with activity of p85 subunit of PI3K [PMID
15068957]

diabetes can be induced by knocking out both insulin receptor substrates
(IRS); low levels of IRS-1 in the liver prompt it to make more glucose
(upregulated gluconeogenic enzymes glucose-6 phosphatase and
phosphoenolpyruvate carboxykinase; also increased hepatic nuclear
factor-4 alpha; decreased glucokinase); low levels of IRS-2 made more
triglycerides (it upregulates SREBP-1c and fatty acid synthase and
increased fat accumulation in the liver); blocking both at the same time
lead to fatty liver disease (hepatic steatosis), glucose intolerance and
insulin resistance, defective Akt activation and Foxo1 phosphorylation
[PMID 15711641]
erach27@gmail.com - 24 Mar 2008 11:50 GMT
heard of "urine therapy" ---- 156,000 web pages on google.
Erach
Kumar - 25 Mar 2008 04:57 GMT
> I think you're asking what you do to keep IRS-1 and/or IRS-2 from
> downregulating.  There's an extensive literature for this.  I don't
[quoted text clipped - 24 lines]
> insulin resistance, defective Akt activation and Foxo1 phosphorylation
> [PMID 15711641]

Should we not check if all conventional diabetic medication programme
to increase insulin senstiviy and availabilty can be directly or
indirenctly related to;

Insulin degradation
http://edrv.endojournals.org/cgi/content/full/19/5/608#F1

Insulin Oscillations
http://en.wikipedia.org/wiki/Insulin_release_oscillations

Downregulation
http://en.wikipedia.org/wiki/Downregulation

Abnormalities in insulin's exposure, normal degradation & oscillation
can cause increased exposure to target cells resulting downregulation
so decreased senstivity.
 
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