What is the underlying mechanism of insulin resistance?

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From the Research

Insulin resistance occurs when cells in the body become less responsive to insulin, preventing efficient glucose uptake, primarily due to defects in the insulin signaling pathway, as described in the most recent study 1. The primary mechanism involves defects in the insulin signaling pathway, particularly at the insulin receptor and post-receptor levels. When insulin binds to its receptor, it normally triggers a cascade of intracellular events including phosphorylation of insulin receptor substrates (IRS) and activation of phosphatidylinositol 3-kinase (PI3K), which ultimately leads to glucose transporter 4 (GLUT4) translocation to the cell membrane for glucose uptake. In insulin resistance, this pathway becomes impaired due to several factors including:

  • Lipid accumulation in tissues (particularly intramuscular and liver fat)
  • Chronic inflammation with increased cytokines like TNF-α and IL-6
  • Oxidative stress
  • Mitochondrial dysfunction
  • Endoplasmic reticulum stress These factors lead to serine/threonine phosphorylation of IRS proteins rather than tyrosine phosphorylation, inhibiting the normal insulin signaling cascade. Additionally, genetic factors, obesity, physical inactivity, and certain medications can contribute to insulin resistance by exacerbating these cellular mechanisms, as supported by studies 2, 3, 4. The body compensates by producing more insulin (hyperinsulinemia), but eventually this compensation fails, potentially leading to type 2 diabetes, and is also associated with an increased risk of cancer, as suggested by recent research 5.

References

Research

Changes in Cells Associated with Insulin Resistance.

International journal of molecular sciences, 2024

Research

Insulin resistance: definition and consequences.

Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association, 2001

Research

Regulation of insulin receptor function.

Cellular and molecular life sciences : CMLS, 2007

Research

Insulin Resistance and Cancer: In Search for a Causal Link.

International journal of molecular sciences, 2021

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