CLINICAL QUERIES: Understanding insulin resistance
Martha Mitchell Funnell MS, RN, CDE

March 2012 
Volume 42  Number 3
Pages 62 - 62
  PDF Version Available!

How does exogenous insulin decrease hyperglycemia in patients with type 2 diabetes with insulin resistance?-D.B., IDAHOMartha Mitchell Funnell, MS, RN, CDE, replies: To answer this question, I'll first explain the pathophysiology of type 2 diabetes. Type 2 diabetes is a heterogeneous group of conditions that constitutes 90% of all diabetes cases in the United States.1,2 Although type 1 diabetes results from absolute insulin deficiency, type 2 diabetes results from both insulin resistance and relative insulin deficiency with increased hepatic glucose production.1,2 In other words, patients with type 1 diabetes have almost a complete lack of insulin production. Patients with type 2 diabetes are resistant to the insulin produced by the pancreatic beta cells, and these cells also produce less insulin.1-4Insulin resistance is thought to occur before insulin deficiency in most patients with type 2 diabetes.1 Initially, the body can produce additional insulin to compensate, which is why patients

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