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Insulin action and resistance in obesity and type 2 diabetes

Michael P. Czech
- 01 Jul 2017 - 
- Vol. 23, Iss: 7, pp 804-814
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TLDR
This Perspective reviews alternate viewpoints and recent results on the temporal and mechanistic connections between hyperinsulinemia, obesity and insulin resistance and connects insulin resistance to extensive metabolic cross-talk between the liver, adipose tissue, pancreas and skeletal muscle.
Abstract
Nutritional excess is a major forerunner of type 2 diabetes. It enhances the secretion of insulin, but attenuates insulin's metabolic actions in the liver, skeletal muscle and adipose tissue. However, conflicting evidence indicates a lack of knowledge of the timing of these events during the development of obesity and diabetes, pointing to a key gap in our understanding of metabolic disease. This Perspective reviews alternate viewpoints and recent results on the temporal and mechanistic connections between hyperinsulinemia, obesity and insulin resistance. Although much attention has addressed early steps in the insulin signaling cascade, insulin resistance in obesity seems to be largely elicited downstream of these steps. New findings also connect insulin resistance to extensive metabolic cross-talk between the liver, adipose tissue, pancreas and skeletal muscle. These and other advances over the past 5 years offer exciting opportunities and daunting challenges for the development of new therapeutic strategies for the treatment of type 2 diabetes.

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Journal ArticleDOI

Mechanisms of Insulin Action and Insulin Resistance

TL;DR: This work aims to develop an integrated physiological perspective, placing the intricate signaling effectors that carry out the cell-autonomous response to insulin in the context of the tissue-specific functions that generate the coordinated organismal response.
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Pathophysiology of Type 2 Diabetes Mellitus.

TL;DR: This review analyzes the key aspects of type 2 Diabetes Mellitus, as well as the molecular mechanisms and pathways implicated in insulin metabolism leading to T2DM and insulin resistance, and summarizes the data gathered up until now.
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The integrative biology of type 2 diabetes.

TL;DR: Recent studies providing insights into insulin resistance and increased hepatic gluconeogenesis associated with obesity and type 2 diabetes are summarized, focusing on data from humans and relevant animal models.
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Biochemical and cellular properties of insulin receptor signalling

TL;DR: In the past decade, major progress has led to the delineation of mechanisms of glucose transport, lipid synthesis, storage and mobilization, which will accelerate the discovery of new treatment modalities for diabetes.
References
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Journal ArticleDOI

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TL;DR: Assessment of dynamic imaging of 18F-2-deoxy-glucose uptake into midthigh muscle and in vivo and ex vivo assessments indicate that impaired glucose transport plays a key role in insulin resistance of NIDDM and obesity and that an additional impairment of glucose phosphorylation is evident in the insulin resistance.
Journal ArticleDOI

Targeting Fat: Mechanisms of Protein Localization to Lipid Droplets

TL;DR: The major known pathways of protein targeting to LDs are reviewed and a classification framework based on the localization origin for the protein is suggested, which summarizes knowledge for targeting and removal of the different classes, and highlights areas needing investigation.
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Controlled-release mitochondrial protonophore reverses diabetes and steatohepatitis in rats.

TL;DR: A controlled-release oral formulation of DNP, called CRMP (controlled-release mitochondrial protonophore), that produces mild hepatic mitochondrial uncoupling, which reduced hypertriglyceridemia, insulin resistance, hepatic steatosis, and diabetes in rat models and was not associated with any systemic toxicity.
Journal ArticleDOI

Insulin signalling mechanisms for triacylglycerol storage.

TL;DR: New findings include activation of DNA-dependent protein kinase to stimulate upstream stimulatory factor (USF)1/USF2 heterodimers, enhancing the lipogenic transcription factor sterol regulatory element binding protein 1c (SREBP1c) and upregulation of a novel carbohydrate response element bindingprotein β isoform that potently stimulates transcription of lipogenic enzymes.
Journal ArticleDOI

Insulin regulates adipocyte lipolysis via an Akt-independent signaling pathway

TL;DR: A noncanonical Akt-independent, phosphoinositide-3 kinase (PI3K)-dependent pathway that regulates adipocyte lipolysis using restricted subcellular signaling is described that selectively alters the PKA phosphorylation of its major lipid droplet-associated substrate, perilipin.
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How long does it take to regulate insulin resistance?

Although much attention has addressed early steps in the insulin signaling cascade, insulin resistance in obesity seems to be largely elicited downstream of these steps.