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25cm; direction: ltr; color: rgb(0, 0, 0); line-height: 120%; }p.western { font-family: “Liberation Serif”, “Times New Roman”, serif; font-size: 12pt; }p.cjk { font-family: “Noto Sans CJK SC Regular”, “Times New Roman”; font-size: 12pt; }p.ctl { font-family: “FreeSans”, “Times New Roman”; font-size: 12pt; }a.western:link { }a.ctl:link { }Several pieces of evidence from our clinical studies suggest that high Insulin Resistance and high Fasting Plasma Insulin levels can be found at an early age. There is indirect evidence that individuals with high insulin resistance become hyperglycemic eventually.

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High insulin resistance and plasma insulin can be observed in patients even before hyperglycemia is evident. Also the association of CAD, Fatty liver and stroke are very high in individuals with high insulin resistance. Hence, we would like to suggest that long-term treatment of Diabetes Type 2 with insulin may not be beneficial instead life-threatening to the patients whereas regular exercise enhances insulin sensitivity delaying the onset of hyperglycemia and/or the vascular complications of Diabetes. Usually, the diagnosis of Diabetes type 2 is determined through the blood glucose measurement. We would like to add that using a patient’s glucose levels alone for Diabetes type 2 diagnosis is a “fundamentally flawed strategy” and fasting Insulin level estimation should be included as the investigation arm in the treatment of Diabetes Type 2 and in the health check.CONCLUSIONThe insulin-signaling cascade is an evolutionally conserved signaling pathway among diverse species that plays a critical role in the regulation of metabolism and longevity. Our data strongly suggest that there is a specific defect in the transduction of the insulin signal through IRS-1 during insulin resistant states which could be reversed by physical exercises. The effect of exercise on insulin action is supported by our findings that exercised rats show improved insulin sensitivity with increased translocation of glucose transporters along with diminishing G6Pase activity.

These data provide considerable progress in our understanding of the molecular events that link physical exercise to an improved insulin signaling in tissues. Combining our previous clinical study with the present it clearly indicates that complications of Diabetes type 2 is largely associated with hyperinsulinemia than with hyperglycemia. Hence the management of Diabetes type 2 should be directed mostly in controlling the high insulin levels rather than high glucose levels along with the inclusion of Fasting Insulin level estimation for monitoring for Diabetes type 2 and regular health check-ups. Also, our study reinforces the importance of regular exercise, as the therapeutic management of insulin resistant from further leading to type 2 diabetes and other complications also Acknowledgements


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