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Insulin Pancreatic hormone Stimulation of cellular uptake of glucose, amino acids and lipids Stimulation of lipogenesis, glycogenesis, and protein synthesis Increases storage of glucose, fatty acids, and amino acids as glycogen, triglycerides and proteins. Maintenance of normal plasma glucose levels in spite of large changes due to food intake. After a meal Rapid uptake of dietary glucose > glucose transport > glucose utilization Utilization of dietary glucose > glycogen synthesis > glucose oxidation > lipid synthesis During a fast Preservation of energy stores < glycogen degradation < gluconeogenesis < lipolysis < proteolysis Insulin Resistance Genetic factors and acquired factors Primarily obesity Metabolic Syndrome Hyperglycemia/IGT Dyslipidemia Hypertension Endothelial dysfunction/ Microalbuminuria Hypofibrinolysis Inflammation Insulin has anti-inflammatory effect Insulin resistance with or without obesity is associated with increase in cytokines possibly responsible for inflammation-like effects: TNF alpa Soluble CD40 VCAM/ICAM expression NF-kB RAGE expression. Contributes to Atherosclerosis McFarlane S, et al. (2001). J Clin Endocrinol Metab. 86:713–718 Glucagon Mobilization of glucose by increasing glycogenolysis and gluconeogenesis Mobilization of fatty acids by increasing lipolysis Increased amino acid catabolism