Hormonal
Insulin resistance in the myocardium serves as a protective mechanism against glucolipotoxicity by limiting glucose entry; overriding this resistance with high-dose insulin leads to mitochondrial dysfunction, oxidative stress, and cardiac injury.
Your body's insulin resistance in the heart is a shield against nutrient overload. Forcing more insulin into your system removes this shield, allowing too much glucose and fat into heart cells, which damages them. Respecting this resistance is key to heart health.
We propose that the myocardium is 'safeguarded' against glucolipotoxicity by IR... treating patients with poorly controlled T2D with large amounts of exogenous insulin could override this block against glucose entry, providing all the ingredients for glucolipotoxicity.
Why this rating
Supported by human studies showing increased myocardial lipid content with insulin treatment and rodent models showing cardiac dysfunction.
Source
Insulin Resistance as a Physiological Defense Against Metabolic Stress: Implications for the Management of Subsets of Type 2 Diabetes
Christopher J. Nolan et al. · Diabetes · 2015
DOI 10.2337/db14-0694
More from this paper
- In overweight or obese patients with type 2 diabetes and severe insulin resistance, overriding insulin resistance with high-dose exogenous insulin therapy can induce insulin-mediated metabolic stress, leading to myocardial glucolipotoxicity and increased cardiovascular mortality.Good
- Intensive lifestyle interventions that reduce nutrient load (weight loss) improve cardiovascular outcomes in obese type 2 diabetes patients, whereas intensive insulin therapy in similar patients increases mortality.Good
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