The 10th Aesthetic Medicine Congress of South Africa – Dr. Sly Nedic Lecture
GENETIC PREDISPOSITION FOR INSULIN RESISTANCE, CARDIO-METABOLIC SYNDROME, AND TYPE 2 DIABETES
Insulin resistance is a widely used clinical term. It is usually defined as a state characterized by reduced glucose-lowering activity of insulin but is also sometimes used as a shorthand label for a clinical syndrome encompassing major pathologies of Metabolic Syndrome. Actually, cellular insensitivity to the action of insulin is termed insulin resistance. Insulin Resistance also means the cells of the body do not respond appropriately to insulin: due to either direct insulin resistance at the cellular level or through the countering of the action of insulin by the counter-regulatory hormones.
Insulin resistance can be present with various clinical symptoms, diseases, and dysfunctions such as:
- Type 2 diabetes
- Polycystic ovarian syndrome (PCOS)
- Non-alcoholic fatty liver disease(NFLD)
- Cognitive decline — type 3 diabetes
- Erectile dysfunction
- Sleep apnea
- Cancer (breast, prostate, colon cancer)
- End-stage renal disease (ESRD).
The majority of patients with Insulin resistance present with an increased Waist to Hip ratio (stubborn belly fat) and with tiredness, that is often left without attention for a long time and only get addressed once serious symptoms appear.
Insulin is a gene expression modulator involved in many biochemical processes in the body such as: a) Glucose metabolism and keeping normal glucose homeostasis b) Fat mobilization and synthesis c) Protein metabolism d) Oxidative stress and inflammatory response e) Mitochondrial function f) Cytokine synthesis g) Adrenal and sex hormone metabolism. Prevalent IR usually results from a genetic predisposition interacting with acquired obesity, however even in some lean individuals very severe degrees of IR are seen and it is almost always genetically predisposed. It is important to identify these single genes defects as patients can early benefit from molecular diagnosis, genetic counseling, and tailored therapies before disease become irreversible.
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