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Teach Not to Hate Insulin

Nurse caring about elder man

Man, 63 years of age, type 2 diabetes, obesity, hypertension and hyperlipidemia, referred to me, a CDE, to start him on and teach him how to use insulin. He has had diabetes education in the past, tried lower carb eating and physical activity, but glucose levels still elevated. He told me he felt like a failure. He said he learned he was insulin resistant, made too much insulin, which was causing his co-morbidities. He was very resistant to start insulin, especially since he thought insulin was the cause of his problem.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #59: Mechanisms of insulin signal transduction Part 3 of 8

DeFronzoCover

Insulin receptor substrate molecules -- receptor substrate/docking protein: Following insulin binding and receptor autophosphorylation, the next committed step in signal transduction is tyrosine phosphorylation of intracellular proteins. To accomplish this, autophosphorylation of the beta subunit mediates noncovalent but stable interactions between the receptor and intracellular substrate proteins, and this positions these molecules for tyrosine phosphorylation by the activated insulin receptor kinase.

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