![]() ![]() Current interventions for IR include intensive lifestyle interventions, thiazolidinedione, DPP-4 inhibitors, and metformin. Improving IR may provide a therapeutic strategy for controlling T2D, obesity, and many other diseases. IR is associated with increased risk for other associated disorders, including polycystic ovary syndrome (PCOS), hepatitis C virus, nonalcoholic fatty liver disease (NAFLD), and metabolic syndrome ( Diamanti-Kandarakis and Dunaif, 2012 Meex and Watt, 2017 Aytug et al., 2003). These complications bring a tremendous medical and socioeconomic burden. The risk of dementia, Alzheimer’s disease, and cognitive decline are elevated in people with IR ( Biessels et al., 2006 Willette et al., 2015 Kullmann et al., 2016) and T2D the global prevalence of diabetic foot pathologies is 6.3%, and 12.9 to 49.0 million people worldwide have a history of foot ulceration ( Armstrong et al., 2017 Zhang P. There are many vascular and nerve-related complications in diabetes such as diabetes-induced dysregulation of cardiac function, instability of microvasculature of the heart, and increased risk for heart failure ( Riehle and Abel, 2016 Levelt et al., 2016 Hinkel et al., 2017). Closely linked to the epidemic of obesity ( Ng et al., 2014), the number of adults with diabetes increased from 108 million in 1980 to 422 million in 2014 ( Zhou et al., 2016), and this figure is projected to rise to 642 million people by 2040. et al., 2014) and inflammation in visceral adipose tissue is a main driver of IR ( Lumeng et al., 2007). Some studies have pointed out that body mass index is positively associated with IR ( Li W. ![]() IR and obesity are connected with chronic inflammation in metabolic tissues such as adipose tissue and the liver ( Winer et al., 2016). Prospective studies have highlighted the importance of IR in the pathogenesis of T2D and suggest that IR is the best predictor of future T2D diagnosis ( Lillioja et al., 1993). During IR, the body’s compensatory release of excess insulin to maintain blood sugar stability causes hyperinsulinemia that can progress to type 2 diabetes mellitus (T2D). Insulin resistance (IR) is a pathological condition in which target tissues (primarily skeletal muscle, liver, and adipose tissue) have an impaired biological response to insulin stimulation. This article reviews studies of the target mechanisms of herbal treatments for insulin resistance. Improved insulin sensitivity upon treatment with herbal medicine provides considerable prospects for treating insulin resistance. The targets involved in these studies include insulin receptor substrate, phosphatidylinositol 3-kinase, glucose transporter, AMP-activated protein kinase, glycogen synthase kinase 3, mitogen-activated protein kinases, c-Jun-N-terminal kinase, nuclear factor-kappaB, protein tyrosine phosphatase 1B, nuclear factor-E2-related factor 2, and peroxisome proliferator-activated receptors. Numerous of in vitro and in vivo studies have pointed out that the role of herbal medicine in improving insulin resistance is related to interventions in various aspects of the insulin signaling pathway. ![]() ![]() These studies involve not only the single-flavored herbs, but also herbal formulas, extracts, and active ingredients. Many clinical trials have suggested the potential role of herbs in the treatment of insulin resistance, although most of the clinical trials included in this review have certain flaws and bias risks in their methodological design, including the generation of randomization, the concealment of allocation, blinding, and inadequate reporting of sample size estimates. This increased workload of the pancreas and the consequent decompensation are not only the main mechanisms for the development of type 2 diabetes (T2D), but also exacerbate the damage of metabolic diseases, including obesity, nonalcoholic fatty liver disease, polycystic ovary syndrome, metabolic syndrome, and others. Although often expressed as an increase in insulin concentration, the disease is characterized by a decrease in insulin action. Insulin resistance is a condition in which insulin sensitivity is reduced and the insulin signaling pathway is impaired. ![]()
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