Hyperinsulinemia

Hyperinsulinemia
Other namesHyperinsulinaemia
Insulin binding to its receptor
SpecialtyEndocrinology Edit this on Wikidata

Hyperinsulinemia is a condition in which there are excess levels of insulin circulating in the blood relative to the level of glucose. While it is often mistaken for diabetes or hyperglycaemia, hyperinsulinemia can result from a variety of metabolic diseases and conditions, as well as non-nutritive sugars in the diet.[1] [better source needed] While hyperinsulinemia is often seen in people with early stage type 2 diabetes mellitus, it is not the cause of the condition and is only one symptom of the disease [citation needed] (for opposing view see review in [2]). Type 1 diabetes only occurs when pancreatic beta-cell function is impaired. Hyperinsulinemia can be seen in a variety of conditions including diabetes mellitus type 2, in neonates and in drug-induced hyperinsulinemia. It can also occur in congenital hyperinsulinism, including nesidioblastosis.

Hyperinsulinemia is associated with hypertension, obesity, dyslipidemia, insulin resistance, and glucose intolerance.[3] These conditions are collectively known as metabolic syndrome.[4] This close association between hyperinsulinemia and conditions of metabolic syndrome suggest related or common mechanisms of pathogenicity.[3] Hyperinsulinemia has been shown to "play a role in obese hypertension by increasing renal sodium retention".[3]

In type 2 diabetes, the cells of the body become resistant to the effects of insulin as the receptors which bind to the hormone become less sensitive to insulin concentrations resulting in hyperinsulinemia and disturbances in insulin release.[5] With a reduced response to insulin, the beta cells of the pancreas secrete increasing amounts of insulin in response to the continued high blood glucose levels resulting in hyperinsulinemia. In insulin resistant tissues, a threshold concentration of insulin is reached causing the cells to uptake glucose and therefore decreases blood glucose levels. Studies have shown that the high levels of insulin resulting from insulin resistance might enhance insulin resistance.[5]

Studies on mice with genetically reduced circulating insulin suggest that hyperinsulinemia plays a causal role in high fat diet-induced obesity. In this study, mice with reduced insulin levels expended more energy and had fat cells that were reprogrammed to burn some energy as heat.[6]

Hyperinsulinemia in neonates can be the result of a variety of environmental and genetic factors. If the mother of the infant is a diabetic and is not able to properly control her blood glucose levels, the hyperglycemic maternal blood can create a hyperglycemic environment in the fetus. To compensate for the increased blood glucose levels, fetal pancreatic beta cells can undergo hyperplasia. The rapid division of beta cells results in increased levels of insulin being secreted to compensate for the high blood glucose levels. Following birth, the hyperglycemic maternal blood is no longer accessible to the neonate resulting in a rapid drop in the newborn's blood glucose levels. As insulin levels are still elevated this may result in hypoglycemia. To treat the condition, high concentration doses of glucose are given to the neonate as required maintaining normal blood glucose levels. The hyperinsulinemia condition subsides after one to two days.[7]

  1. ^ Ballantyne, Sarah, "Is It Paleo? Splenda, Erythritol, Stevia, and Other Low-Calorie Sweeteners", 03 Jan 2015, https://www.thepaleomom.com/paleo-splenda-erythritol-stevia-low-calorie-sweeteners/ (last accessed 02 Sept 2020).
  2. ^ Michael H. Shanik, Yuping Xu, Jan Škrha, Rachel Dankner, Yehiel Zick, Jesse Roth; Insulin Resistance and Hyperinsulinemia: Is hyperinsulinemia the cart or the horse?. Diabetes Care 1 February 2008; 31 (Supplement_2): S262–S268. https://doi.org/10.2337/dc08-s264
  3. ^ a b c Modan, Michaela; Halkin H; Almog S; Lusky A; Eshkol A; Shefi M; Shitrit A; Fuchs Z (March 1985). "Hyperinsulinemia: A link between hypertension obesity and glucose intolerance". J. Clin. Invest. 75 (3): 809–17. doi:10.1172/JCI111776. PMC 423608. PMID 3884667.
  4. ^ Danker, Rache; Chetrit A; Shanik MH; Raz I; Roth J (August 2009). "Basal-stat hyperinsulinemia in healthy normoglycemic adults is predictive of type 2 diabetes over a 24-year follow-up". Diabetes Care. 32 (8): 1464–66. doi:10.2337/dc09-0153. PMC 2713622. PMID 19435961.
  5. ^ a b Shanik, M.H.; Yuping, X.; Skrha, J.; Danker, R.; Zick, Y.; Roth, J. (2008). "Insulin Resistance and Hyperinsulinemia". Diabetes Care. 31 (2): S262–68. doi:10.2337/dc08-s264. PMID 18227495.
  6. ^ Arya E. Mehran; Nicole M. Templeman; G. Stefano Brigidi; Gareth E. Lim; Kwan-Yi Chu; Xiaoke Hu; Jose Diego Botezelli; Ali Asadi; Bradford G. Hoffman; Timothy J. Kieffer; Shernaz X. Bamji; Susanne M. Clee; James D. Johnson (6 Dec 2012). "Hyperinsulinemia Drives Diet-Induced Obesity Independently of Brain Insulin Production". Cell Metabolism. 16 (5): 723–37. doi:10.1016/j.cmet.2012.10.019. PMID 23217255.
  7. ^ Ferry, R.J. (2010). Hyperinsulinism "Medscape".