Are fat cells more sensitive to high doses of insulin?

Dr. Jack Merendino, MD
Endocrinology Diabetes & Metabolism
The answer to this question is a little complicated. On the one hand, fat cells respond more as insulin levels in the blood stream go up. The more insulin there is, whether it is made by the body or given as a medication, the more the fat cells will respond by storing energy. On the other hand, as body fat increases -- especially with increasing fat in the liver and other intra-abdominal organs -- fat cells become somewhat resistant to insulin. Insulin resistance means that more and more insulin is required to have the same action. In a person who is insulin resistant, the same amount of insulin will have a much lesser effect on fat cells than it would have in a person who is not insulin resistant.

The obvious question that arises in this setting is what makes fat cells insulin resistant in people with too much abdominal fat. Despite many years of research into this question, it is still not completely clear what causes insulin resistance, but it appears that the intra-abdominal fat cells themselves make a variety of hormones and other chemical signals that lessen the body’s responsiveness to insulin.
Kelly Traver
Internal Medicine

All cells have insulin receptors. But for some reason, the fat cells remain sensitive to insulin, even when the muscle cells become more resistant. So, the sugar is preferentially let into the fat cells rather than the muscle cells. Once inside the fat cells, the sugar is not used for creating ATP; instead, it is just used to store fat. This is handy if starvation is right around the corner (as it often was for our prehistoric ancestors), but for most people today, this is an issue. The real zinger here is that fat cells secrete a chemical that encourages the muscles' insulin receptors to become less sensitive. This means that the pancreas has to churn out more insulin (which the fat cells grab), the fat cells become even fatter and secrete more of their chemicals, and the vicious cycle continues. It is important to keep your insulin receptors as sensitive as possible throughout your entire life. This is crucial for staying healthy and aging well, not just for preventing diabetes.

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