Insulin Resistance and Method of it Diagnosis in Patients with Essential Hypertension

Abstract

Insulin resistance occurs in a considerable number of diseases, especially in all the patients with obesity and hypertension and in almost 50% of slim patients with essential hypertension. Mechanisms leading to prereceptor, receptor and postreceptor insulin resistance with special auention paid to those changes which may occur in essential hypertension have been discussed in this study The methods used to diagnose insulin resistance are based on simultaneous measuring of insulin and glucose concentration in blood serum. The most exact methods of estimating insulin resistance consist in measuring glucose and insulin concentration in serum during steady-state, quantitatively defined glucose or insulin infusion at such a speed that the physiological glucose concentration in blood serum can be maintained. Both methods however- i. e. steady-state plasma glucose as well as metabolic clamp are laboratorious and tiresome for the patient. Nuclear magnetic resonance and administrating marked glucose, insulin, amino acids and fats have been used to estimate the degree of insulin sensitivity. The insulin clamp method, however, still remains the golden standard. High relationship between binding to erythrocyte receptors and insulin resistance measured by clamp technique glues the possibility of rapid and exact estimation of insulin sensitivity in patients with essential hypertension.