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Diabetes Congress 2019
Journal of Diabetology | Volume 3
Page 22
June 24-25, 2019 | Philadelphia, USA
DIABETES, ENDOCRINOLOGY, NUTRITION
AND NURSING MANAGEMENT
2
nd
International Conference on
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
alliedacademies.comYEARS
INSULINE RESISTANCE–PATHOGENESIS, PREVENTION AND TREATMENT
E Mukhamejanov
JSC National Medical University, Kazakhstan
T
he mechanism of development of insulin resistance (IR) is not clear. This makes it difficult to develop ade-
quate ways to prevent and treat type 2 diabetes mellitus (2D). There is no free glucose in the muscle tissue,
upon admission it is immediately phosphorylated to glucose-6-phosphate (G-6-F), which prevents its return.
With a decrease in the rate of G-6-F conversion, hexokinase is inhibited and the intake of glucose into the
muscles decreases. This regulatory process can be considered as the first mechanism of development of IR.
The next phosphorylation already produces fructose-6-di-phosphate, which is also a regulatory molecule, and
its accumulation will also inhibit the absorption of glucose (the second stage of development of IR). The next
regulatory step is the process of assimilation of pyruvic acid or the so-called pyruvate block, since a decrease
in anaerobic or aerobic conversion of pyruvate promotes inhibition of glycolysis and the development of IR.
The next step in the regulation of glucose conversion is ATP or the level of utilization of the energy of its oxi-
dation. The most volatile process in the muscle cell is protein synthesis, so the amount of glucose utilization
will directly correlate with the rate of protein synthesis. With a decrease in protein synthesis with a substrate
deficit or inhibition of the protein of the synthesizing apparatus, the utilization of ATP decreases and the ATP/
ADP coefficient increases, which contributes to the inhibition of hexokinase and the development of IR. Such
mechanism of development of IR will allow developing effective ways of developing the principles of preven-
tion and treatment of patients with 2D.
J Diabetol 2019, Volume 3