In der heutigen Zeit, die durch beschleunigte Lebensgewohnheiten, übermäßigen Stress, leichten Zugang zu ungesunden Lebensmitteln und mangelnde Zeit für körperliche Aktivitäten geprägt ist, erleben wir zunehmend Störungen des Kohlenhydratstoffwechsels – die Zahl der Diabetes-Typ-2-Fälle steigt. Es werden jedoch auch andere Zustände diagnostiziert, die weniger schwerwiegend sind, aber zu Diabetes Typ 2 führen können – einer davon ist die Insulinresistenz, an der zwischen 10 und 30% der Bevölkerung leiden.
The physiological role of insulin and the pathophysiological basis of insulin resistance: a comprehensive endocrine perspective
Insulin constitutes a pivotal peptide hormone synthesized by the β-cells (beta cells) of the pancreatic islets of Langerhans, whose secretion is triggered in response to postprandial elevations in blood glucose concentrations. Its primary physiological function involves facilitating the transmembrane transport of glucose into target cells—most notably skeletal myocytes, hepatocytes, and adipocytes—through binding to specific membrane-bound receptors and initiating the PI3K/Akt signaling cascade. Beyond this, insulin orchestrates anabolic processes, including muscular glycogen synthesis (the storage of glucose as glycogen), enhances the uptake of essential amino acids for muscle protein synthesis (via activation of the mTORC1 pathway), and modulates lipid metabolism by suppressing lipolysis while promoting lipogenesis in adipose tissue (Brzozowski, 2019).
Conversely, insulin resistance (IR) denotes a pathological condition characterized by diminished responsiveness of peripheral tissues to insulin action despite maintained fasting euglycemia, leading to compensatory hyperinsulinemia. The progression of this dysfunction culminates in impaired glucose tolerance and, ultimately, chronic hyperglycemia, which serves as the primary risk factor for the development of type 2 diabetes mellitus. Furthermore, IR is closely associated with metabolic syndrome (abdominal obesity, dyslipidemia with hypertriglyceridemia, arterial hypertension) and exhibits links to the pathogenesis of affective disorders, including major depressive episodes (Mamcarz et al., 2015; Watson et al., 2021).
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