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Clinical Presentations

PowerPoint Presentations that you can use for your own presentations. All presentations are created by Medical professionals in diabetes care.

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #136: Pathogenesis of Type 2 Diabetes Mellitus Part 7

Cellular mechanisms of insulin resistance: The cellular events via which insulin initiates its stimulatory effect on glucose metabolism start with binding of the hormone to specific receptors that are present on the cell surface of all insulin target tissues. After insulin has bound to and activated its receptor, “second messengers” are generated and these second messengers activate a cascade of phosphorylation-dephosphorylation reactions that result in stimulation of intracellular glucose metabolism. The first step in glucose utilization involves activation of the glucose transport system, leading to glucose influx into insulin target tissues, primarily muscle. The free glucose, which has entered the cell, subsequently is metabolized by a series of enzymatic steps that are under the control of insulin. Of these, the most important are glucose phosphorylation (catalyzed by hexokinase), glycogen synthase (which controls glycogen synthesis), and phosphofructokinase (PFK) and PDH (which regulate glycolysis and glucose oxidation, respectively).

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