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The objective of this volume is to summarize the current state of knowledge about insulin resistance.
List of contents
Section 1. Pathophysiology of insulin resistance.
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1.1 Introduction.
1.2 Normal physiology.
1.2.1 Hormonal regulation of metabolism.
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1.2.2 The insulin receptor.
1.2.3 Post-binding events.
1.2.4 Glucose metabolism.
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1.2.5 Lipid metabolism.
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1.2.6. Protein metabolism.
1.2.7. Ion transport.
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1.3 The concept of insulin resistance.
1.3.1 Early studies of insulin action.
1.4 Definitions of insulin resistance.
1.5 Assessment of insulin action in vivo.
1.5.1 Fasting insulin concentration.
1.5.2 Dynamic tests - endogenous insulin.
1.5.3 Dynamic tests - exogenous insulin.
1.5.4 Mathematical modelling techniques.
1.5.5 The insulin suppression test.
1.5.6 The hyperinsulinaemic euglycaemic clamp technique.
1.6. Mechanisms of insulin resistance.
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1.6.1 Genetic causes of insulin resistance.
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1.6.2 Acquired causes of insulin resistance.
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1.6.3.Fetal origins hypothesis.
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Further Reading.
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Section 2. Insulin resistance in clinical medicine.
2.1 Clinical features.
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2.2 Factors influencing insulin sensitivity.
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2.2.1 Normal variation in insulin action.
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2.2.2 Sex.
2.2.3 Age.
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2.2.4 Physical activity.
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2.2.5 Tobacco.
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2.2.6 Alcohol.
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2.3. Physiological states of insulin resistance.
2.3.1 Puberty.
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2.3.2 Pregnancy.
2.3.4 The menopause.
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2.4 Severe insulin resistance syndromes.
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2.5 Insulin resistance and cardiovascular risk.
2.5.1 Syndrome X.
2.5.2 Obesity.
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2.5.3 Regional adiposity.
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2.5.4 Impaired glucose tolerance.
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2.5.5 Type 2 diabetes.
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2.5.6 Essential hypertension.
2.5.7 Dyslipidaemia.
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2.5.8 Endothelial dysfunction.
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2.5.9 Microalbuminuria.
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2.5.10. Hyperuricaemia.
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2.5.11 Impaired Fibrinolysis.
2.5.12 Polycystic ovary syndrome.
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2.5.13 Non-alcoholic steatohepatitis.
2.6 Other disorders associated with insulin resistance.
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2.6.1 Counter-regulatory hormone secretion.
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2.6.2 Endocrinopathies.
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2.6.3 Chronic renal failure.
2.6.4 Cirrhosis.
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2.6.5 Cardiac failure.
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2.7 Miscellaneous inherited disorders.
2.8 Drug-induced insulin resistance.
Further Reading.
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Section 3. Management of insulin resistance and associatedconditions.
3.1 Non-pharmacological measures.
3.1.1 Medical nutrition therapy.
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3.1.3 Alcohol.
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3.1.4 Tobacco.
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3.2 Drugs for type 2 diabetes.
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3.2.1 Biguanides.
3.2.2 Thiazolidinediones.
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3.2.3 Sulphonyulreas.
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3.2.4 Repaglinide.
3.2.5 a-glucosidase inhibitors.
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3.2.6 Insulin therapy.
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3.3 Anti-obesity drugs.
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3.4 Lipid-modifying drugs.
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3.5 Anti-hypertensive drugs.
3.6 Experimental therapies
