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Microvascular contributions to insulin resistance

journal contribution
posted on 2023-05-22, 02:08 authored by Stephen RattiganStephen Rattigan, Stephen RichardsStephen Richards, Michelle Keske

The notion that type 2 diabetes and insulin resistance are associated with many macro- and microvascular defects (1,2) is unquestionable, but whether vascular defects precede and contribute to insulin resistance is less certain and has been a controversial topic. The most compelling evidence for a vascular involvement in insulin resistance has been in skeletal muscle (3), but recent research has also implicated its involvement in adipose tissue (4), which may then lead to whole body insulin resistance via inflammation (5).

The suggestion that the vasculature may be a potent contributor to insulin resistance in muscle came from early, indirect clinical studies in which insulin resistance was inversely associated with skeletal muscle capillary density in Pima Indians (6) and from studies of total blood flow during euglycemic-hyperinsulinemic clamps in normal and insulin-resistant subjects (7). Many subsequent studies by various research groups have reported corroborating data that vascular defects (especially in the microvasculature) can contribute to insulin resistance in muscle (rev. in 3 and reference list therein). The underlying consequence of the vascular defect is impaired delivery of insulin and/or glucose to the skeletal myocyte, which leads to insulin resistance. Because the muscle myocyte (and other tissues) also exhibit defects in insulin signaling and responsiveness in established states of obesity, hypertension, and diabetes (all of which are associated with insulin resistance), the significance of a vascular contribution is often questioned or undervalued.

Funding

Heart Foundation

History

Publication title

Diabetes

Volume

62

Pagination

343-345

ISSN

0012-1797

Department/School

Menzies Institute for Medical Research

Publisher

Amer Diabetes Assoc

Place of publication

1701 N Beauregard St, Alexandria, USA, Va, 22311-1717

Rights statement

Copyright 2013 American Diabetes Association

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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