Insulin sensitivity glucocorticoids

Walker, B. R, Connacher, A. A., Lindsay R. M., Webb, D. J., Edwards, C. R. (1995) Car-benoxolone increases hepatic insulin sensitivity in man a novel role for 11-oxosteroid reductase in enhancing glucocorticoid receptor activation. J Clin Endocrinol Metab 80, 3155-3159. 

Increased insulin sensitivity and a flattened glucose tolerance curve, which may reflect decreased antagonism by glucocorticoids. 

The history and presentation indicate hypopituitarism. This causes an increase in insulin sensitivity due to the relative deficiency of glucocorticoids and growth hormone. It was correct, therefore, to use a lower dose of insulin. 

Destruction of the adrenal cortex results in a deficiency of glucocorticoids, mineralocorticoids and androgens, and the features of the disease are a reflection of this. Mineralocorticoid deficiency leads to sodium deficiency, which in turn leads to dehydration and this can present as an Addisonian crisis. The deficiency of glucocorticoids leads to hypoglycaemia and pronounced insulin sensitivity with a flat glucose tolerance curve. Because of the glucocorticoid deficiency, the pituitary produces maximal... 

The increased levels of catecholamines and glucocorticoids, the increased sympathetic activity and the decreased level of insulin increase the activity of hormone-sensitive lipase in adipose tissue that is responsible for the increased rate of lipolysis. Also important are the proinflammatory cytokines, TNFa, interleukins 1 and 6. The significance of fat as a fuel in trauma explains why the cytokines have a... 

Glucocorticoids increase serum glucose levels and thus stimulate insulin release and inhibit the uptake of glucose by muscle cells, while they stimulate hormone sensitive lipase and thus lipolysis. The increased insulin secretion stimulates lipogenesis and to a lesser degree inhibits lipolysis, leading to a net increase in fat deposition combined with increased release of fatty acids and glycerol into the circulation. 

Growth hormone, corticotropin, thyrotropin, luteinizing hormone, thyroid hormone, insulin, glucocorticoids, progesterone, erythropoietin, renin Increased body temperature Sensitization of pain-mediating nerve fibers Increased force of myocardial contraction... 

Insulin stimulates peripheral tissue protein synthesis by stimulating amino acid uptake and protein synthesis at the level of translation and by inhibiting protein degradation. At low insulin levels, muscle proteolysis occurs. As the levels increase, proteolysis decreases and protein synthesis is favored. Exercise decreases proteolysis and increases protein synthesis, whereas disuse results in muscle wasting and depressed protein synthesis. Exercise increases sensitivity to insulin, whereas disuse makes the tissue insulin-resistant. Obesity, pregnancy, and glucocorticoids also increase insulin resistance. 

Insulin release is stimulated by a variety of hormones. Glucagon and ACTH Induce Instilln release In vitro and vivo by a mechanism which may be related to their effect on Intracellular concentrations of cyclic. 14,29 Glucocorticoids and growth hormone affect insulin by Increasing the sensitivity of the B-cells to stimulation by glucose.>31... 

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