Venue Details:

https://us06web.zoom.us/meeting/register/tZAocOCtqjoqHtFYQgn3Z2dWhU8RILWtxgiJ

Description:

In this talk, Dr Passman will be discussing why Metabolic syndrome and Insulin

Resistance are important to detect early and the issues with current testing as well

as looking at other biomarkers such as apolipoproteins for identifying and monitoring

patients.

IR has been described as a condition where a greater than normal amount of insulin

is required to obtain a quantitatively normal response. It is a state of reduced

responsiveness in insulin-targeting tissues to high physiological insulin levels.

IR is considered the pathogenic driver of metabolic syndrome, non-alcoholic fatty

liver disease (NAFLD), atherosclerosis and Type 2 Diabetes Mellitis (T2DM).

Insulin resistance and the metabolic syndrome result from the interplay of

environmental and genetic factors. Endocrine disorders including Cushings

syndrome, Acromegaly and Hypothyroidism as well as Polycystic Ovarian Syndrome

are also associated with Insulin resistance. The metabolic syndrome comprises a

group of conditions that increase the risk of developing heart disease, stroke, and

type 2 diabetes. In addition metabolic dysfunction has been associated with both

increased risk of numerous malignancies as well as Alzheimers Dementia. The

demonstration of Insulin resistance and related risk factors for metabolic dysfunction

are crucial for identifying high risk individuals. The Gold standard for diagnosing

insulin resistance is the hyperinsulinaemia euglycaemic clamp. The clamp method is

labour intensive, costly and impractical. Surrogate markers for identification of insulin

resistance include the homeostasis model assessment (HOMA) and quantitative

insulin sensitivity check index. Both algorithms use fasting glucose and insulin levels

and show fairly good correlation with the clamp method. Although the lipid profile is

essential for the diagnosis of Metabolic Syndrome, newer modalities including

Apolipoprotein assays (ApoB and ApoA1) as well as Lipoprotein (a) may prove more

useful for identifying and monitoring response to treatment. Treatment of insulin

resistance should be mostly focused on lifestyle modification targeting healthy

eating, moderate exercise and weightloss. Adjunctive surgical intervention (bariatric

surgery) and medical treatment including Metformin and the newer GLP-1 analogues

may also be indicated.

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