In many scientific works the conclusion about the adaptive significance of insulin resistance was formed. There is evidence that insulin hypersecretion may precede and cause insulin resistance. In this regard, a reason is important that forces the organism to reduce the sensitivity of tissues to insulin. In the present review, the authors propose to discuss the issues, which are the tissues with diabetes vulnerable to damage. Where must push glucose during intensive therapy of diabetes mellitus, aimed at euglycemia? The vulnerability of cells is determined by the degree of sensitivity, the volume of blood perfusion, the functional significance of the tissue. The sensitivity of the cells is determined by tissue type; its functional activity; share of the total integrated activity of the organism; functional reserve capacity; degree of energy and plastic deficit. Excess effect of insulin on the tissue is hypoxia and accumulation of glycogen. Insulin therapy does not prevent development of degenerative lesions in the kidneys, brain, retina and heart muscle. In terms of complex treatment of diabetes mellitus type 2 and normalization of carbohydrate metabolism does not occur full repara-tion of membrane systems due to the continuity of intensive insulin therapy. Prolonged exposure to insulin in excessive doses leads to damage accumulation and the development of complications makes the disease incurable. The need to develop mechanisms to protect cells from damage is evident. The authors suggest that to reduce the tension caused by hyperinsulinemia, insulin resistance is not sufficient. Damage triggers compensatory mechanisms. The practice of continuous use of high doses of insulin to overcome insulin resistance should be terminated. It is necessary to revise the indications for insulin therapy and its duration.
diabetes type 2 diabetes, hyperinsulinemia, cell damage.
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