Rangraze Imran Rashid, El-Tanani Mohamed, Arman Rabbani Syed, Babiker Rasha, Matalka Ismail I, Rizzo Manfredi
Internal Medicine Department, RAK College of Medical Sciences, RAK Medical and Health Sciences University, Rasal- Khaimah, United Arab Emirates.
College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.
Curr Diabetes Rev. 2025;21(9):e15733998311738. doi: 10.2174/0115733998311738240813110032.
In this complex realm of diabetes, hyperinsulinemia is no longer regarded as just a compensatory response to insulin resistance but rather has evolved into an integral feature. This comprehensive review provides a synthesis of the current literature, including various aspects associated with hyperinsulinemia in diabetic complications. Hyperinsulinemia has been shown to be more than just a compensatory mechanism, and the key findings demonstrate how hyperinsulinism affects the development of cardiovascular events as well as microvascular complications. Additionally, recognizing hyperinsulinemia as a modifiable factor, the diabetes management paradigm shifts towards cognitive ones that consider the use of lifestyle modifications in combination with newer pharmacotherapies and precision medicine approaches. These findings have crucial implications for the clinical work, requiring a careful appreciation of hyperinsulinemia's changing aspects as well as incorporation in personalized treatment protocol. In addition, the review focuses on bigger issues related to public health, showing that prevention and early diagnosis will help reduce the burden of complications. Research implications favor longitudinal studies, biomarker discovery, and the study of emerging treatment modalities; clinical practice should adopt global evaluations, patient education, and precision medicine adaptation. Finally, this critical review provides an overview of the underlying processes of hyperinsulinemia in diabetes and its overall health effects.
在糖尿病这个复杂领域，高胰岛素血症不再仅仅被视为对胰岛素抵抗的一种代偿反应，而是已演变成一个不可或缺的特征。这篇全面综述对当前文献进行了综合，涵盖了与糖尿病并发症中高胰岛素血症相关的各个方面。高胰岛素血症已被证明不仅仅是一种代偿机制，关键研究结果表明高胰岛素血症如何影响心血管事件以及微血管并发症的发生发展。此外，认识到高胰岛素血症是一个可调节因素后，糖尿病管理模式转向认知模式，即考虑结合生活方式改变、新型药物疗法和精准医学方法。这些发现对临床工作具有至关重要的意义，需要仔细认识高胰岛素血症不断变化的方面，并将其纳入个性化治疗方案。此外，该综述关注与公共卫生相关的更大问题，表明预防和早期诊断将有助于减轻并发症负担。研究意义在于支持纵向研究、生物标志物发现以及新兴治疗模式的研究；临床实践应采用全面评估、患者教育和精准医学应用。最后，这篇批判性综述概述了糖尿病中高胰岛素血症的潜在机制及其对整体健康的影响。
