Insulin resistance syndrome

Clinic

• Also referred to as syndrome X or the metabolic syndrome

• It is characterized by metabolic abnormalities, including
  • Impaired glucose tolerance
  • Insulin resistance
  • Hypertension
  • Dyslipidemia
  • Central obesity
  • Coagulation abnormalities favoring thrombosis
  • Hyperuricemia
  • PCOS
• Together, these abnormalities create a metabolic environment that increases the risks of macrovascular atherosclerotic abnormalities, such as stroke, heart attack, peripheral vascular disease, as well as renal failure.
• The presence of insulin resistance is important, because this condition precedes, and ultimately progresses to, type 2 diabetes.

Sign / Symptoms

• Primary amenorrhea
• Oligomenorrhea
• Ovarian Cysts
• Hirsutism
• Acanthosis nigricans
• Type A insulin resistance syndrome are usually not overweight.
• The features of type A insulin resistance syndrome are more subtle in affected males.
• Some males have hypoglycemia as the only sign; others may also have acanthosis nigricans.
• In many cases, males with this condition come to medical attention only when they develop diabetes mellitus in adulthood.

Type A insulin resistance

• It is a rare disorder characterized by severe insulin resistance, a condition in which the body's tissues and organs do not respond properly to insulin.
• Insulin resistance impairs blood sugar regulation and ultimately leads to a condition called diabetes mellitus.
• It is one of a group of related conditions described as inherited severe insulin resistance syndromes including
  • Donohue syndrome
  • Rabson-Mendenhall syndrome
  • Type A insulin resistance syndrome represents the mildest end of the spectrum.

Type B insulin resistance = TBIR

• Type B insulin resistance is a very rare form of diabetes and is usually a component of an autoimmune disorder.
• Most people have an underlying autoimmune disorder esp lupus or a closely related disorder.
• Sometimes, people may already have a diagnosis of lupus or a similar condition when they develop TBIR. However, sometimes TBIR is the first sign of an autoimmune disease in people who do not have a known autoimmune disorder.
• Rarely, TBIR occurs in people who have certain types of cancer usually lymphoma or multiple myeloma, the cancer cells make the abnormal antibodies that bind to the insulin receptor.
• In TBIR, the body makes abnormal antibodies that attach to normal insulin cell receptors and blocks the good effects of insulin. Therefore glucose can’t get into cells normally, causing high blood sugars. This form of impaired insulin action resembles severe diabetes, but not the same.
• TBIR is commonly associated with underlying autoimmune diseases, such as SLE, various connective tissue diseases, interstitial lung disease or organ-specific dermatological, haematological, or hepatic disorders.

Miasms

HCV