This is probably silly question but why is it that more insulin is produced when cells display insulin resistance? What's the point of producing more insulin when the cells are already resistant to insulin?
I heard that there is also leptin resistance. Does this also works the same way? Produce more leptin to make up for the resistance?
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Hormonal resistance means that the body isn't responding to normal levels of a hormone. In the case of insulin resistance, the tissues for some reason aren't responding to normal insulin levels, so the local environment is that of low insulin levels. Low insulin levels correspond to less glucose uptake and high levels of blood glucose. High blood glucose levels stimulate the pancreas to secrete more insulin via negative feedback. This is why insulin resistance can result in hyperinsulinemia (higher-than-normal levels of insulin in the blood), which in turn can lead to type 2 diabetes when the pancreas is no longer able to secrete enough insulin to restore blood glucose levels to normal (
Hyperinsulinemia: Is it diabetes? - Mayo Clinic)
Then again, there is this....
Is this from section bank? I don't understand this...
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Fetal development is tricky because you need to consider two different environments: the mother and the developing fetus. High blood glucose levels during fetal development pertains to some problem in the maternal environment, which means the developing fetus is exposed to external hyperglycemia. That's not a good thing since ultimately after labor and delivery, the newborn should be able to produce normal blood glucose levels on their own for normal functioning. Increased exogenous levels of glucose stimulates the newborn's pancreas to release insulin to increase glucose uptake. But insulin also prevents the usage of the newborn's internal glucose reserves because the total amount of glucose is already high. If the newborn can't use their own glucose reserves, their blood glucose levels will be lower than normal and the resulting hypoglycemia will result in neurological problems since the brain relies heavily on glucose.
Think of this situation to be similar to injecting someone with a large amount of glucose. This injection is an external source of glucose, which increases the total amount of glucose in the blood. The body responds to lower the total amount of glucose by releasing insulin to stimulate glucose uptake. But the body doesn't distinguish between internal and external sources of glucose, since lowering the total amount of glucose is more important, which means the body's own glucose reserves aren't being utilized. Increased glucose uptake and decreased usage of endogenous glucose reserves result in a net decrease in blood glucose levels from normal conditions. This phenomenon is called hyperinsulinemic hypoglycemia (see here for more info:
Hyperinsulinemic hypoglycemia - Wikipedia)
Hyperinsulinemic hypoglycemia can occur in type 1 diabetes patients who have to rely on insulin injections because their bodies are unable to produce insulin on their own. When they accidentally skip a meal, they have higher levels of insulin and thus low levels of glucose, resulting in a medical emergency called insulin shock (
Insulin Shock: Warning Signs and Treatment Options and
Diabetic hypoglycemia - Mayo Clinic)
So here, because the newborn is exposed to high glucose levels during development, the newborn will have high insulin levels preventing usage of endogenous glucose reserves and leading to hypoglycemia. To counter this, infusing with an insulin antagonist like glucagon will stimulate the usage of glucose reserves, restore glucose levels to normal and prevent neurological problems.
