Waldhäusl W
Klinischen Abteilung für Endokrinologie und Stoffwechselkrankheiten, Medizinischen Universitätsklinik III. Wien.
Acta Med Austriaca. 1992;19(4):96-100.
Insulin sensitivity of insulin dependent tissues (muscle, adipose tissue, liver) is subject to a variety of influences. Any change in insulin sensitivity is compensated in healthy subjects by a dynamic change in insulin secretion, which will decrease following a rise in insulin sensitivity and increase if insulin sensitivity is impaired (i.e. during insulin resistance induced by obesity, pregnancy, oral contraceptives, dehydration, saturated fatty acids, fever, drugs, etc.). In contrast to secondary insulin resistance idiopathic insulin resistance in type 2 diabetic individuals is associated with impaired insulin secretion, which thus is unable to overcome impaired insulin sensitivity. Idiopathic insulin resistance in type 2 diabetes is additionally characterized by reduced glucose storage, the basis of which may reside in an insulin receptor defect, in the presence of insulin receptor antibodies, in a postreceptor defect or in the synthesis of abnormal insulin molecules.
胰岛素依赖组织（肌肉、脂肪组织、肝脏）的胰岛素敏感性受到多种因素影响。在健康受试者中，胰岛素敏感性的任何变化都会通过胰岛素分泌的动态变化得到补偿，胰岛素敏感性升高时胰岛素分泌会减少，而胰岛素敏感性受损时（即肥胖、妊娠、口服避孕药、脱水、饱和脂肪酸、发热、药物等引起胰岛素抵抗时）胰岛素分泌会增加。与继发性胰岛素抵抗不同，2型糖尿病患者的特发性胰岛素抵抗与胰岛素分泌受损有关，因此无法克服胰岛素敏感性受损的问题。2型糖尿病中的特发性胰岛素抵抗还具有葡萄糖储存减少的特征，其基础可能在于胰岛素受体缺陷、存在胰岛素受体抗体、受体后缺陷或异常胰岛素分子的合成。
