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         Insulin Resistance:     more books (100)
  1. Syndrome X: The Complete Nutritional Program to Prevent Reverse Insulin Resistance by Jack; Berkson, Burt; Smith, Melissa Diane Challem, 1999
  2. Don't miss signs of insulin resistance. (First Clinical Guidelines Issued).: An article from: Pediatric News by Heidi Splete, 2002-10-01
  3. Rising obesity rates boosting liver disease risk: the typical patient with nonalcoholic fatty liver disease has a BMI above 30 and insulin resistance.(Across ... An article from: Clinical Psychiatry News by Miriam E. Tucker, 2004-08-01
  4. Caffeine worsens insulin resistance in prediabetics.(Metabolic Disorders): An article from: Family Practice News by Jeff Evans, 2007-04-15
  5. Insulin resistance seen in 54% of overweight teens.(Metabolic Disorders): An article from: Family Practice News by Christine Kilgore, 2005-08-15
  6. Insulin resistance in 5% of youngsters.(News): An article from: Family Practice News by Michele G. Sullivan, 2005-07-01
  7. Insulin Resistance by Frederic P. Miller, Agnes F. Vandome, et all 2010-01-19
  8. Insulin resistance theory advanced: tied to Alzheimer's, depression.(News): An article from: Clinical Psychiatry News by Michele G. Sullivan, 2003-10-01
  9. Novel prognostic factors in IgA glomerulonephritis: Insulin resistance, inflammation and alcohol consumption by Kati Kaartinen, 2009-11-12
  10. Science & Medicine Magazine Sept/Oct 1994 (Vol. 1 No. 4, H. Pylori Binding, Arterial Plaques, Sickle Cell Anemia, Insulin Resistance) by various, 1994
  11. Insulin Resistance: An Overview (Endocrinology)
  12. Syndrome X The Complete Nutritional Program to Prevent and Reverse Insulin Resistance 2001 publication. by Mlisa Dian Smit, 2001
  13. Insulin resistance implicated in lupus-linked atherosclerosis. (Normal Glucose Maintained).: An article from: Internal Medicine News by Nancy Walsh, 2003-06-01
  14. Exploring the roots of diabetes: bisphenol a may promote insulin resistance.(Environews / Science Selections): An article from: Environmental Health Perspectives by Cynthia Washam, 2006-01-01

61. Insulin Resistance Syndrome - 2nd World Congress
Clinical manifestation of the insulin resistance Syndrome and it s relations to Obesity, Dyslipidemia , Cardiovascular Disease, HTN, PCOS, Gestational Diabetes
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62. Insulin Resistance And Hyperinsulinemia
insulin resistance AND HYPERINSULINEMIA. What are insulin resistance (IR) and hyperinsulinemia? Why is insulin resistance medically important?
http://www.health-alliance.com/hospitals/Jewish/glueck/insulin_resistance.htm
Home Hospitals Jobs webBabies ... News INSULIN RESISTANCE AND HYPERINSULINEMIA What are insulin resistance (IR) and hyperinsulinemia? Beta cells in the pancreas produce insulin. Insulin stimulates uptake of glucose (sugar) from the blood to the cells in the body. When the body's cells are resistant to the action of the insulin, it is called insulin resistance (IR). As a result of the insulin resistance, the pancreas produces much more insulin than normal. This is called hyperinsulinemia (Figures 1,2). As an example, in a normal person, 1 unit of insulin might be needed to help 10 mg of glucose go into the cell, but in a hyperinsulinemic person, 10 units of insulin might be needed to get the same 10 mg of glucose into the cell (Figure 2). With hyperinsulinemia and IR come a myriad of problems including the following:
  • high triglycerides (increased risk of heart and stroke) high plasminogen activator inhibitor activity (PAI-Fx), causing increased risk of clotting low HDL cholesterol (increased risk of heart attack and stroke) high uric acid (gout) polycystic ovary syndrome (endocrine disorder with oligo-amenorrhea, infertility, hirsutism, obesity, high Leptin levels

63. News Releases
EINSTEIN RESEARCHERS FINDINGS SHED LIGHT ON insulin resistance THAT CONTRIBUTES TO ONSET OF DIABETES. January 15, 2003 (BRONX
http://www.aecom.yu.edu/home/news/resistin.htm
EINSTEIN RESEARCHERS' FINDINGS SHED LIGHT ON
INSULIN RESISTANCE THAT CONTRIBUTES TO ONSET OF DIABETES January 15, 2003 (BRONX, NY) Researchers at the Albert Einstein College of Medicine have successfully demonstrated how the protein resistin alters insulin action in the liver. The team, led by Dr. Luciano Rossetti, reports their findings in the January 15 issue of the Journal of Clinical Investigation . While previous research on resistin had established that the protein is formed and secreted by fat cells and can alter glucose tolerance and insulin action, until now, the protein's role in the liver was not known.
Insulin's main task in the body is to restrain the liver from producing excessive amounts of glucose and to stimulate cells to take in glucose, which they use for energy. Dr. Rossetti and his colleagues found that resistin , which is secreted by fat cells in the circulation, impairs the effect of insulin on liver cells. This condition, known as insulin resistance, is a risk factor for diabetes as well as other health problems including hypertension and heart disease.
Dr. Rossetti's findings help explain why obesity - with its excess number of fat cells in the body - is closely linked to diabetes. "We have been discussing the perils of obesity with regard to diabetes for many years," said Dr. Rossetti, who is the Judy R. and Alfred A. Rosenberg Faculty Scholar in Diabetes Research at Einstein and director of the medical school's Diabetes Research Center. "We know that when people get fat their fat cells get bigger and they become resistant to the effects of insulin and prone to getting diabetes.

64. Diabetic Guidelines, Diabetic Protocols, Insulin Resistance, HbA1c, Diagnosing D
Insulin Kinetics. Select an insulin (kinetics).
http://www.globalrph.com/diabetic_therapy.htm
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65. Insulin Resistance - Wikipedia, The Free Encyclopedia
insulin resistance. From Wikipedia, the free encyclopedia. In medicine, insulin of clamping studies. Causes of insulin resistance.
http://en.wikipedia.org/wiki/Insulin_resistance
Insulin resistance
From Wikipedia, the free encyclopedia.
In medicine insulin resistance denotes a decompensation of glucose homeostasis where the tissues appear to be less responsive to insulin. Table of contents 1 Introduction 2 Pathophysiology 3 Investigation 3.1 Hyperinsulinemic euglycemic clamp ... edit
Introduction
In patients who use insulin , "insulin resistance" is production of antibodies against insulin that lead to lower-than-expected falls of glucose levels after a given dose of insulin.
Insulin resistance denotes decreased sensitivity of target cells (muscle, fat cells) to insulin. It is the metabolic cause the very common " Syndrome X ", which is the clustering of diabetes mellitus (type 2), hypertension combined hyperlipidemia and central obesity in patients. It also underlies most processes behind polycystic ovarian syndrome (PCOS). edit
Pathophysiology
In a normal person, a small amount of insulin is produced after eating ("postprandial"), and it signals the body to absorb the sugars from the food at a steady rate. In an " insulin resistant " person the message does not get to the cells so the sugar remains in the blood for long periods of time while ever more insulin is released in an attempt to trigger the sugar-uptake. The sugar circulates in the blood for several hours and then is taken into the cells very rapidly, leading to a steep drop in bloodsugar and a

66. Callalil's PCOS Pages - Natural Remedies For PCOS And Insulin Resistance
Natural Remedies for PCOS and insulin resistance. Progesterone Creams. Many women have had success using progesterone cream to produce
http://pcos.freeservers.com/natural.html
Free Web site hosting - Freeservers.com Web Hosting - GlobalServers.com Choose an ISP NetZero High Speed Internet ... Dial up $14.95 or NetZero Internet Service $9.95
Natural Remedies for PCOS and Insulin Resistance
Progesterone Creams
Many women have had success using progesterone cream to produce regular periods after experiencing PCOS-related amenhorrea as an alternative to taking Provera. If you have been using progesterone cream and think you may be pregnant, be sure that you aren't before you stop using it because it is possible that suddenly stopping could cause a miscarriage.
Cinnamon
Glutamine
Glutamine is an amino acid which has been shown in animal studies to prevent high blood sugar and insulin levels in mice that were susceptible to developing high sugar levels when fed a high-fat diet.
Polyunsaturated Fatty Acids (omega-3 and omega-6 fatty acids)
Help keep cell membranes flexible. Flexible cell membranes have more and better insulin receptors, which improves glucose metabolism. Flax seed and some kinds of deep-sea fish have them - you can get it in capsules too - borage oil, black currant oil, evening primrose oil, flax seed oil, fish oil.
Chromium
Chromium deficiency produces symptoms of diabetes and insulin resistance, including high blood sugar levels, decreased sensitivity of insulin receptors, lower HDL (good) cholesterol and high total cholesterol and triglyceride levels. Modern diets that are rely heavily on sugar and refined grains (white flour and white rice, for example) aggravate chromium deficiency because more chromium is used to metabolize them than is replaced by the foods. Chromium picolinate seems to be the most bio-available form, though GTF chromium has been studied longer and is recommended by Drs. Rachael and Richard Heller, authors of the Carbohydrate Addict's Diet books; 200 mcg/day of either may prevent diabetes in those predisposed to it and improve insulin resistance symptoms.

67. Method Found To Reduce Insulin Resistance
A new method to reduce insulin resistance that could lead to treatments for type 2 diabetes has been patented by two researchers.
http://diabetes.about.com/cs/insulinresistance/a/blnreduceIR304.htm
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Method Found to Reduce Insulin Resistance
from Newswise
MSH antagonists decrease glucagon in the bloodstream
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68. Insulin Resistance Information For Patients | Type 2 Diabetes And Insulin Resist
insulin resistance, or the inability of the body to use the insulin it produces effectively, is associated with type 2 diabetes, cardiovascular disease, and
http://diabetes.about.com/cs/insulinresistance/a/insulin_resist.htm
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Insulin Resistance Information
From Paula Ford-Martin
Your Guide to Diabetes
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Insulin Resistance and Diabetes

Insulin Resistance

Insulin Resistance and Hyperinsulinemia
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Type 1 Diabetes and Insulin Resistance

New research points to a role for insulin resistance in the development of heart disease in people with type 1 diabetes. Find out more about "double diabetes."

69. Insulin Resistance And The Carnivore Connection Hypothesis
insulin resistance/part 1 high incidence of diabetes in former huntergatherers may be due to insulin resistance, an adaptation to meat-based diets.
http://www.beyondveg.com/billings-t/comp-anat/comp-anat-7k.shtml
(Comparative Anatomy and Physiology Brought Up to Datecontinued, Part 7K)
Insulin Resistance: The Carnivore Connection
Hypothesis of Miller and Colagiuri [1994]
THE PROBLEM: Incidence of adult- onset diabetes varies depending on recency of a population's exposure to agriculture.

This section is based on Miller and Colagiuri [1994]. The carnivore connection hypothesis they elucidate provides an explanation, based on evolution, of the following phenomenon:
  • Populations that have a relatively "long" history of agriculture, e.g., those of European descent, have a relatively low incidence of NIDDM, that is, non- insulin- dependent diabetes mellitus, also known as adult- onset diabetes.
  • Populations that adopted agriculture more recently or, in other words, discontinued the evolutionary hunter- gatherer diet more recently, have relatively higher incidence rates of NIDDM. In some former hunter- gatherer populations, incidence levels of NIDDM range from epidemic levels (Nauruans; the Pima tribe of the U.S.), to rates that are "only" several times that of Europeans.

THE HYPOTHESIS: Overview
The carnivore connection is a hypothesis that explains the above in terms of insulin resistance and partial adaptation to the high- carbohydrate diets introduced via agriculture. The major points of the hypothesis are as follows (from Miller and Colagiuri [1994

70. Ific.org : The Ins And Outs Of Insulin Resistance
IFIC.org Food Insight Newsletter 2000 May/June The Ins and Outs of insulin resistance. The Ins and Outs of insulin resistance. Food Insight May/June 2000.
http://www.ific.org/foodinsight/2000/mj/insulinfi300.cfm
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Sugars do not cause hyperactivity.
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Search Options Site Map IFIC.org ... May/June The Ins and Outs of Insulin Resistance The Ins and Outs of Insulin Resistance
Food Insight
May/June 2000
What is insulin resistance? To better understand insulin resistance, let's review some basic biochemistry. Insulin is a hormone produced by the islet cells of the pancreas. When blood glucose (blood sugar) rises after food is eaten, the pancreas pumps out insulin, whose job is to shuttle glucose into cells, where glucose is used for energy or stored as glycogen. To do its job, insulin must fit like a key into receptors lining the outside of the cell. Each cell contains 20,000 or more insulin receptors. Once inserted in the cell's receptors, insulin activates an enzyme in the receptors called tyrosine kinase. This triggers a series of events that allows glucose to enter the cell. With insulin resistance, the cells "resist" this process, so instead of entering the cell, glucose builds up in the blood. The pancreas responds by pumping out higher than normal levels of insulin in an attempt to reduce blood glucose to normal levels. What causes insulin resistance?

71. Clinical Trial: Ginkgo Biloba Extract And The Insulin Resistance Syndrome
Ginkgo Biloba Extract and the insulin resistance Syndrome. This study is currently recruiting patients. Sponsored by. National Center
http://www.clinicaltrials.gov/show/NCT00032474
Home Search Browse Resources ... About Ginkgo Biloba Extract and the Insulin Resistance Syndrome This study is currently recruiting patients. Sponsored by National Center for Complementary and Alternative Medicine (NCCAM) Purpose The purpose of this study is to examine whether the ingestion of the herbal dietary supplement Ginkgo biloba extract has any effect on the efficacy of three classes of diabetic medications - (Glucotrol, Glucophage and Actose). Additionally, the study will examine the effect of Ginkgo biloba extract on pancreatic insulin production in non-diabetic subjects between the ages of 20 and 75 years old. Condition Treatment or Intervention Phase Type 2 diabetes mellitus
Drug: Ginkgo biloba extract
Phase I

Phase II

MedlinePlus
related topics: Diabetes
Study Type: Interventional
Study Design: Treatment, Randomized, Double-Blind, Placebo Control, Crossover Assignment, Pharmacokinetics/Dynamics Study Further Study Details: Eligibility Ages Eligible for Study: 20 Years - 80 Years, Genders Eligible for Study: Both

72. Beth Israel Deaconess In The News
Fat Cell Defect May Trigger insulin resistance in Muscle And Liver. All of the mice showed insulin resistance similar to that found in human obesity.
http://home.caregroup.org/newsnow/pr_out.asp?pr_id=122

73. ERI Patents Treatments For Insulin Resistance In Diabetes Accompanying Obesity
ERI patents treatments for insulin resistance in diabetes accompanying obesity. 31 Mar 2004
http://www.medicalnewstoday.com/index.php?newsid=6916

74. The Latest Research On Overcoming Insulin Resistance
insulin resistance is a term that describes the diminished sensitivity of cells to the signaling effects of insulin. It is especially
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The latest research on overcoming insulin resistance Insulin resistance is a term that describes the diminished sensitivity of cells to the signaling effects of insulin. It is especially found in patients with type 2 diabetes, but also found in patients with type 1 diabetes. When we eat, our blood glucose, or sugar, levels rise. That rise prompts the pancreas to secrete insulin into the circulation. Insulin binds to specific proteins on the surfaces of cells, which leads to the stimulation of glucose transport into muscle and fat cells, where it is used or stored. In diabetes, several steps in this pathway are impaired, which leads to prolonged elevations of blood sugar. Researchers are identifying what factors, such as hormones, receptors, and other cellular proteins, are implicated in this process and its malfunction, in hopes of developing a strategy to overcome insulin resistance. Among the hormones gaining attention are those made by cells of the intestinal tract. In response to food, these hormones are released into the blood to stimulate the pancreas to release more insulin. In a very real sense, the signal brought to the pancreas by glucose is amplified by the presence of these intestinal tract hormones. GLP-1 is the most potent of these and is receiving attention from investigators. Other factors that may contribute to insulin resistance are amylin, secreted from the pancreas, and leptin and tumor necrosis factor-alpha, secreted from fat cells. Another hormone, adiponectin, also secreted by fat cells, decreases insulin resistance.

75. Conditions And Diseases - Insulin Resistance Top Links
insulin resistance Web Site Links. The insulin resistance Syndrome Discussion of the causes, consequences and treatment of insulin resistance.
http://www.disease-resources.com/Top_Health_Conditions_and_Diseases_Endocrine_Di
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Related Healthcare Subjects Disabilities Environmental Health Fitness Health Insurance ... Men's Health
Insulin Resistance Web Site Links The Glycemic Index: Flogging a Dead Horse? Article arguing for the usefulness of the glycemic index.
The Insulin Resistance Syndrome
Discussion of the causes, consequences and treatment of insulin resistance.
Lowering Your Insulin Levels
Information on reducing insulin levels by lowering carbohydrate intake.
Syndrome X/Insulin Resistance Information
One woman's experiences with Syndrome X and tips on living with this disease.
Syndrome X and Insulin Resistance
Column by Pat Kendall, PhD, RD of the Colorado State University Cooperative Extension.
Other Useful Health Web Links National Institutes of Health (NIH) US Government department in charge of medical research.
AHRQ: Clinical Information
Clinical information on evidence-based practice, clinical guidelines, medical effectiveness, pharmaceutical therapy, new technology, screening and preventive services, outcomes research, and the National Guideline Clearinghouse.
The UK Health Technology Assessment Programme
Site contains details of program's many projects and publications; an NHS national research and development initiative.

76. Gerald I. Shulman
Gerald Shulman s group examines insulin resistance in patients with diabetes and in transgenic mouse models of insulin resistance.
http://www.hhmi.org/research/investigators/shulman.html
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ALSO OF INTEREST Search PubMed New Cause of Insulin Resistance Diabetes in the Elderly Diabetes Detectives ... Dr. Shulman's Faculty Page
Cellular Mechanisms of Insulin Resistance
Gerald I. Shulman, M.D., Ph.D.
Investigator,
Yale University School of Medicine Biography... Summary: Gerald Shulman's group examines insulin resistance in patients with diabetes and in transgenic mouse models of insulin resistance. Their long-term objectives are to identify new therapeutic targets to reverse insulin resistance in patients with type 2 diabetes and to identify candidate genes that make individuals prone to this disease. Diabetes is a major health care problem in the United States, affecting ~6 percent of the population over age 18 and ~15 percent of the population over 65. The leading cause of blindness and nontraumatic loss of limb, diabetes accounts for 25 percent of all new cases of end-stage renal failure. More than 90 percent of diabetics have type 2 diabetes. Although the primary factors causing this disease are unknown, it is clear that insulin resistance has a primary role in its development. Our objective is to elucidate the molecular mechanisms behind insulin resistance in patients with type 2 diabetes, in the hope that this will enable the development of therapeutic agents to reverse this pathologic condition, and assist with identification of genes that make individuals prone to this disease. Since liver and muscle are the two key insulin-responsive organs that account for most of the glucose metabolized in humans, we are using nuclear magnetic resonance (NMR) spectroscopy in combination with gas chromatography mass spectrometry to focus on these tissues in normal and diabetic subjects. Our approach has major advantages over existing techniques: it is noninvasive, it involves no ionizing radiation, and repeated measurements of biochemical metabolites in plasma and tissue can be performed that yield localized metabolic flux rates and information on rate-controlling steps of glucose metabolism.

77. HHMI News: Researchers Identify New Cause Of Insulin Resistance
HHMI researchers have tracked the cause of insulin resistance in the offspring of patients with type 2 diabetes to abnormalities in their mitochondria.
http://www.hhmi.org/news/shulman2.html
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ALSO OF INTEREST Diabetes in the Elderly Linked to Fewer Cellular "Power Plants" New Understanding of Insulin's Complexities Needed to Conquer Diabetes Loss of Enzyme Produces Diabetes-Like Symptoms
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Researchers Identify New Cause of Insulin Resistance
"These new findings identify potential new targets for drugs that could either treat or prevent type 2 diabetes," said HHMI investigator Gerald Shulman. Mitochondria are responsible for the breakdown of fatty acids. Impairment of mitochondrial function causes buildup of fats and fatty acids inside muscle that can produce insulin resistance, which, in turn, can contribute to the development of diabetes later in life. The researchers, led by Howard Hughes Medical Institute investigator Gerald I. Shulman , who is also professor of medicine and physiology at Yale, published their findings in the February 12, 2004, issue of the New England Journal of Medicine The hormone insulin promotes the transport of blood glucose into cells for energy production and storage. Mitochondria within the cells convert glucose and fatty acids into energy via oxidation. Type 2 diabetes develops when cells do not respond to insulin, causing accumulations of glucose in the blood.

78. Type 2 Diabetes And Insulin Resistance
What Is insulin resistance? insulin resistance is a core defect of type 2 diabetes. In fact, 1 in 4 Americans may have insulin resistance.
http://www.actos.com/sub_sec4_what_is_in.asp
window.name="actos"; What Is Insulin Resistance? Insulin resistance is a core defect of type 2 diabetes. In fact, 1 in 4 Americans may have insulin resistance. Not sure if you have insulin resistance? Here are some of the common "predictors" of insulin resistance:
  • Being overweight with a BMI ( body mass index ) of 25 kg/m or higher.
    Having body fat located around your waist: more than 40 inches for men and more than 35 inches for women.
    A triglyceride (blood fats) level more than or equal to 150 mg/dL.
    An HDL (good) cholesterol level of less than
    40 mg/dL for men and less than 50 mg/dL for women.
    Blood pressure greater than or equal to
    130/85 mm Hg.
    Fasting blood glucose levels more than or equal to
    110 mg/dL.
If you think you may have insulin resistance, talk to your health professional.
1 of 2 Next Importance of Insulin Resistance Management of type 2 diabetes requires nutritional counseling, weight reduction as needed, and exercise. When diet and exercise are not enough, ACTOS may be used alone or in combination with sulfonylureas, metformin, or insulin to improve blood sugar control. Reference:
  • Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).
  • 79. Type 2 Diabetes And Insulin Resistance
    Back to top. insulin resistance1 insulin resistance is a condition that occurs when insulin is available, but cells do not respond to the insulin s action.
    http://www.actos.com/sub_sec4_glossary.asp
    window.name="actos"; Diabetes Glossary When you're learning how to live with type 2 diabetes, it's the most basic information that will be your foundation for life-long management of your disease. Therefore, it is important that you understand the basic words that you see and hear every day when learning about diabetes. The following is a list of commonly used words and terms that you should know. Understanding what these words mean doesn't have to be difficult and can be one of the most important things you do. Knowing what they mean will help you understand more about diabetes, your treatment program, and how to take care of yourself. The list is provided in alphabetical order to make it easy for you to use. Words that appear in a definition are in bold italics if they also have their own entry. Click on any of the letters below to see the list of diabetes-related words/terms. A — M N — Z A — M Blood glucose/blood sugar levels
    The terms "blood glucose levels" and "blood sugar levels" mean the same thing and either one can be used to describe the amount of glucose (sugar) in the blood. The term "plasma glucose" is also used. You and your healthcare team will set goals for your blood glucose levels. The American Diabetes Association suggests general goals of 90 to 130 mg/dL before meals, with a peak after-meal goal of

    80. Insulin Resistance, Type 2 Diabetes
    Provides online Type 2 diabetes CME conferences about insulin resistance, endocrinology and more. Please wait insulin resistance presentations.
    http://www.cmeondiabetes.com/pub/insulin.resistance.php
    Please wait... loading content about :
    Insulin Resistance presentations
    Français - June 2, 2004 CMEonDiabetes is a website built to transmit top-level CME conferences (slides with voice-over) given by international experts in endocrinology , and also provides conference reports and key study results updated daily, concerning type 2 diabetes: epidemiology pathophysiology and notably insulin resistance prevention and management: lifestyle and behaviour and pharmacologic treatment . This site represents a unique platform for the exchange of medical information on diabetes. The principal themes presented are Insulin Resistance and Type 2 Diabetes. Topic
    Insulin Resistance
    Insulin resistance is often associated with abdominal obesity, is a factor of the metabolic syndrome and is implicated in the development of atherosclerosis. Insulin resistance together with beta cell dysfunction leads to the appearance and gradual progression of type 2 diabetes. Thiazolidinediones, which act on insulin resistance, can slow and perhaps even prevent the progression of type 2 diabetes, where in some cases insulin injections become necessary. Also, treatment of insulin resistance with thiazolidinediones has been shown to ameliorate several complications associated with insulin resistance, such as hypertension, dyslipidemia, hyperinsulinemia, visceral fat, microalbuminuria and hyperglycemia. The conference presentations in this section will explore in intricate detail the nature of insulin resistance, its causes and consequences.

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