Insulin acts on the cells of the body through specific insulin receptors. The process of insulin action begins when its molecules attach to the receptor located on the surface

most body cells. Depending on the given process, its effects may be visible from a few seconds to several hours after binding to the receptor.

In the publication “Insulin resistance in endocrinopathies”, the authors present three mechanisms of disorders that lead to the occurrence of insulin resistance.

1. The mechanism of pre-receptor resistance – may be caused by the incorrect structure of insulin molecules, increased degradation of insulin, the presence of antibodies in the blood that bind insulin molecules, as well as a high concentration of hormones antagonistic to insulin – i.e. cortisol, glucagon, thyroid hormones, androgen hormones or hormone growth,

2. The mechanism of receptor resistance – is associated with a reduced number of insulin receptors or their affinity for insulin. It has been proven that insulin produces its maximum effect in peripheral tissues after saturation of 10% of the receptors.

3. The mechanism of post-receptor resistance is most often associated with disturbances in the intracellular signal transmission, i.e. the signal of insulin binding to the receptor. Post-receptor resistance can also be induced by abnormalities in the structure and operation of glucose transporters into the cell, as well as in the case of strong lipolysis, when the amount of free fatty acids increases, and their excessive oxidation inhibits glycolysis.

Source: Źródło: Wiesław Grzesiuk, Dorota Szydlarska, Katarzyna Jóźwik „Insulin resistance in endocrinopathies”. Via Medica, 2008. ISSN 1734-3321 www.endokrynologia.viamedica.pl