Intensive insulin therapy and microvascular disease) is central to the development of complications of diabetes mellitus. This evidence convinced most physicians who specialize in diabetes care that an important goal of treatment is to make the biochemical profile of the diabetic patient (blood lipids, HbA1c, etc.) as close to the values of non-diabetic people as possible. This is especially true for young patients with many decades of life ahead. A working pancreas continually secretes small amounts of insulin into the blood to maintain normal glucose levels, which would otherwise rise from glucose release by the liver, especially during the early morning dawn phenomenon.
Insulin resistance the likelihood of Type 2 diabetes mellitus. Also, insulin resistance often is associated with a hypercoagulable state (impaired fibrinolysis) and increased inflammatory cytokine levels. Another factor that may promote insulin resistance is Leptin, a hormone produced from the ob gene and adipocytes. Its physiological role is to regulate hunger by alerting the body when it is full. From an adaptation perspective, it is possible that leptin resistance was favorable for survival during periods when food was scarce. Today however studies show that lack of leptin causes severe obesity and is strongly linked with insulin resistance. Leptin replacement in mice with