Insulin Resistance in Children and Adolescents

Overview

Insulin resistance is a simple concept with complex ramifications. The notion that insulin action differs in different people and under different circumstances has been known for a considerable period of time. For example, it has long been recognized that young children with type 1 diabetes are "sensitive" to small changes in insulin dosage, while obese adults with type 2 diabetes may require huge doses of insulin to establish metabolic control. What is more recent is the finding that insulin action differs in a ...

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Overview

Insulin resistance is a simple concept with complex ramifications. The notion that insulin action differs in different people and under different circumstances has been known for a considerable period of time. For example, it has long been recognized that young children with type 1 diabetes are "sensitive" to small changes in insulin dosage, while obese adults with type 2 diabetes may require huge doses of insulin to establish metabolic control. What is more recent is the finding that insulin action differs in a number of different and very common conditions and may in fact be a central contributor to the pathogenesis of some or all of these, including obesity, atherogenesis, type 2 diabetes, the metabolic syndrome, hypertension, hyperandrogenism, polycystic ovarian syndrome and perhaps some types of malignancy. The increasing burden of obesity and its ramifications has firmly and increasingly focused the spotlight on insulin resistance in recent years. Yet most of this attention has been paid to adults and much less to the consequences and causes of insulin resistance in children and teens. This is despite the fact that many of the adult diseases associated with insulin resistance, such as obesity, type 2 diabetes, atherosclerosis, have their origins in childhood. Furthermore, insulin resistance has long been documented in certain circumstances in children and teens with type 1 diabetes (e.g. at disease onset, with episodes of ketoacidosis or poor metabolic control), and is likely an adaptive response contributing to the growth spurt of puberty. More recently, in utero contributions to programming of insulin resistance and its consequences have been brought to light, initially by Barker and his colleagues who have championed the field of 'fetal origins of adult disease.' Given the rapid explosion in research in insulin resistance and its increasing importance throughout the life span, we felt it timely to bring together in one plac

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Product Details

  • ISBN-13: 9781594542152
  • Publisher: Nova Science Publishers, Incorporated
  • Publication date: 2/28/2005
  • Pages: 251

Table of Contents

Ch. 1 Cellular and molecular mechanisms of insulin resistance 1
Ch. 2 Insulin resistance in youth : definition and methods of measurement 31
Ch. 3 Fetal influences on insulin resistance 57
Ch. 4 Puberty and insulin resistance 87
Ch. 5 The metabolic phenotype of pre-diabetes in obese youth 103
Ch. 6 Type 2 diabetes in children and adolescents 121
Ch. 7 Premature adrenarche, polycystic ovary syndrome (PCOS) and insulin resistance 163
Ch. 8 Insulin resistance in type 1 diabetes and other conditions 179
Ch. 9 Therapeutic approaches to insulin resistance in children 209
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