Free fatty acids insulin affecting

Type 2 diabetes is characterized by tissue resistance to the action of insulin combined with a relative deficiency in insulin secretion. A given individual may have more resistance or more beta-cell deficiency, and the abnormalities may be mild or severe. Although insulin is produced by the beta cells in these patients, it is inadequate to overcome the resistance, and the blood glucose rises. The impaired insulin action also affects fat metabolism, resulting in increased free fatty acid flux and triglyceride levels and reciprocally low levels of high-density lipoprotein (HDL). 

Regulation of insulin secretion is affected by numerous factors, such as ftKxl, hormonal and neuronal stimuli, and innic mechanisms. In humans, the principal sub.slratc that stimulates the release of in.sulin from the islet /3-cells is glucose. In addition to glucose, other substrates (c.g., amino acids, free fatty acids, and ketone bodies) also can stimulate insulin. secretion directly. Secretin and ACTH can directly stimulate insulin secretion. Glucagon and other related peptides can increase the secretion of insulin, whereas somatostatin inhibits its secretion. 

An insulin infusion should be considered for severe cases of calcium channel blocker toxicity." Case reports suggest that an intravenous bolus of regular insulin (0.5-1 units/kg) with 50 mL dextrose 50% (0.25 mg/kg for children) followed with a continuous infusion of regular insulin (0.5-1 units/kg per hour) may improve myocardial contractility. The effect of insulin is presently unclear, but it may improve myocardial metabolism that is adversely affected by calcium channel blocker overdoses, such as decreased cellular uptake of glucose and free fatty acids and a shift from fatty acid oxidation to carbohydrate metabolism. This insulin regimen is titrated to improvement in systolic blood pressure over 100 mm Hg and heart rate... 

Insulin sensitivity may be affected by many circulating lipids, which included hypertriglyceridemia and increased free fatty acids (FFAs). Raised plasma FFA level is an important inducer of both peripheral and hepatic insulin resistance because it inhibits insulin signaling [46-50]. In additimi, hypertriglyceridemia is also an important marker of insulin resistance. 

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