Insulin resistance as the basic cause of diabetes mellitus type 2
Sagirova R.I., Verbovoy A.F.

Samara State Medical University

The article analyzes the mechanisms of insulin resistance development as the basic cause of type 2 diabetes. The most important modifiable risk factor for developing type 2 diabetes is obesity, which is accompanied by insulin resistance, the main pathogenetic mechanism of development of type 2 diabetes. Obesity is a chronic polyethological disease that is a part of the metabolic syndrome and develops not only because of a disturbance in the energy balance, but also under the influence of a number of genetic and neurological factors, changes in the functions of the endocrine system, lifestyle and eating behavior. Attention is paid to the violation of insulin sensitivity of muscle, adipose and liver tissue. The article provides a detailed discussion of insulin sensitivity disorders in adipose tissue, manifested by adipose tissue inflammation (cellular infiltration, fibrosis, changes in microcirculation, shift of adipokines secretion), and the oxidative stress. 
The role of pro-inflammatory cytokines secreted by adipose tissue in the development of insulin resistance, as well as hormones and biologically active peptides of adipose tissue (leptin, resistin, adiponectin, interleukin 6 (IL-6), etc.) is described. The article notes the connection between vitamin D3 deficiency and inflammatory markers, as well as a predisposition to obesity, and carbohydrate metabolism disorders.

Key words: diabetes mellitus type 2, obesity, insulin resistance, oxidative stress, leptin, resistin, adiponectin, interleukins, vitamin D3.
For citation: Sagirova R.I., Verbovoy A.F. Insulin resistance as the basic cause of diabetes mellitus type 2 // RMJ. 2017. № 14. P. 1039–1042.