INSULIN RESISTANCE IN THE ISLETS OF LANGERHANS

这个子项目是许多利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 碳水化合物代谢涉及体内葡萄糖的利用，其中大部分由胰岛素驱动。胰岛素是在胰腺的胰岛细胞中产生的。胰岛素有助于将我们血液中的葡萄糖水平保持在相对稳定的水平，因此尽管我们在正常饮食中摄入大量碳水化合物，我们的血糖水平仍保持在正常范围内。产生足够胰岛素以维持正常血糖水平的人被称为正常葡萄糖耐受者（NGT）。 一些身体对胰岛素有抵抗力的人，即胰岛素对他们不那么有效，需要制造更多的胰岛素来维持与NGT人相同的血糖水平。他们通常有一个略高于正常的血糖水平，并被称为糖耐量受损（IGT）。他们没有糖尿病，按照目前的标准，不接受治疗。然而，他们每年有3-9%的风险患上2型糖尿病。因此，他们患糖尿病的风险高于正常水平。 下一类碳水化合物代谢异常涉及糖尿病患者。这些人有高血糖水平，即使他们的身体产生尽可能多的胰岛素，因为它可以。他们需要治疗，用胰岛素和各种口服药物治疗，其中之一是一类被称为噻唑烷二酮（TZD）的药物。这些药物被称为胰岛素增敏剂。 该项目将试图证明胰岛细胞水平的抵抗在IGT和糖尿病的发展中起作用，即，如果我们使用TZD，比如吡格列酮，它可以增强对胰岛素的敏感性，它也会使产生胰岛素的胰岛细胞对它更敏感。这些细胞对胰岛素越敏感，它们产生的胰岛素就越多。这将使这些人的血糖水平保持在正常范围内。如果这一理论被证明是正确的，那么它可能提供了另一个理由，开始用这种胰岛素增敏药物治疗IGT患者，试图延缓这些人糖尿病的发展。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Carbohydrate metabolism involves the utilization of glucose in the body, much of it driven by insulin. Insulin is produced in the islet cells in the pancreas. Insulin helps to keep the level of glucose in our blood at a relatively stable level, so that despite us eating large amounts of carbohydrates in a normal diet, our blood glucose levels stay in the normal range. People who produce enough insulin to maintain normal blood glucose levels are called Normal Glucose Tolerant (NGT). Some people whose bodies are resistant to insulin i.e. insulin is not as effective for them, need to make more insulin to maintain the same blood glucose level as NGT people. They usually have a slightly higher than normal blood glucose level and are termed Impaired Glucose Tolerance (IGT). They do not have diabetes and as per current standards, do not receive treatment. However, they have a 3-9% risk per year of developing Type 2 diabetes. They are therefore at a higher than normal risk for developing diabetes. The next category of abnormal carbohydrate metabolism involves people who have diabetes. These people have high blood glucose levels even though their body produces as much insulin as it can. They need treatment and are treated with insulin and various oral medications, one of which, is a class of drugs known as thiozolidinediones (TZD). These drugs are known as insulin sensitizer. This project will try and prove that resistance at the level of the islet cells plays a role in the development of IGT and diabetes, i.e., if we use a TZD, such a pioglitazone, which is known to enhance sensitivity to insulin, it should also make our islet cells, which produce insulin, more sensitive to it. The more sensitive these cells are to insulin, the more insulin they will produce. This will allow these people to maintain their blood glucose levels in the normal range. If this theory is proven to be true, then it might provide another reason to start treating people with IGT with such insulin sensitizing drugs in an attempt to delay the development of diabetes in these people.