Insulin resistance drug-related

Insulin and Amylin. Insulin is a member of a family of related peptides, the insulin-like growth factors (IGFs), including IGF-I and IGF-II (60) and amylin (75), a 37-amino acid peptide that mimics the secretory pattern of insulin. Amylin is deficient ia type 1 diabetes meUitus but is elevated ia hyperinsulinemic states such as insulin resistance, mild glucose iatolerance, and hypertension (33). Insulin is synthesized ia pancreatic P cells from proinsulin, giving rise to the two peptide chains, 4. and B, of the insulin molecule. IGF-I and IGF-II have stmctures that are homologous to that of proinsulin (see INSULIN AND OTHER ANTIDIABETIC DRUGS). 

An AIDS patient who is being treated with multiple drugs, including AZT, lamivudine, indinavir, ketoconazole, and TMP-SMX, develops breast hypertrophy, central adiposity, hyperlipidemia, insulin resistance, and nephrolithiasis. If these changes are related to his drug treatment, the most likely cause is... 

Therefore, it seems obvious to attack the three major pathophysiological defects in T2D, peripheral insulin resistance, increased HGP in the liver and the loss of first-phase insulin response related to a meal, using lifestyle changes and at least three pharmaceutical drugs. This suggestion is based on a few short-time studies, but longer studies are on their way. 

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