Insulin resistance and Psoriasis

In this podcast Dr. Marc-Andre Cornier, Manuel Valdebran and Victoria Palmer discuss the role of inflammation in insulin resistance, its effects on glucose variability, hyperinsulinemia, and the correlation with cardiovascular disease. Here are the key points discussed: Participant Backgrounds - Dr. Marc-Andre Cornier: Director of the Division of Endocrinology at MUSC with a background in cardiometabolic diseases, fuel metabolism, obesity, and diabetes. - Victoria Palmer: Soon-to-be Dermatology resident, collaborated on the manuscript discussing cardiovascular risks and inflammation in psoriasis patients. - Manuel Valdebran: Dermatologist at MUSC -Discussion Points 1. Role of Inflammation in Insulin Resistance: - Inflammation may contribute to insulin resistance and vice versa. - Genetic and environmental factors contribute to insulin resistance, with inflammation playing a significant role. 2. Insulin Resistance and Hyperinsulinemia: - Insulin resistance often leads to compensatory hyperinsulinemia. - Chronic inflammatory disorders like psoriasis and rheumatoid arthritis are linked to increased cardiovascular risk and insulin resistance. 3. Glucose Variability: - Patients may have normal fasting glucose and A1C levels but show other signs like elevated BMI and triglycerides. - Glucose variability can trigger hyperinsulinemia and inflammation. 4. Screening for Insulin Resistance: - Indicators: Physical signs like acanthosis nigricans, elevated BMI, triglycerides, and low HDL. - Screening Recommendations: Regular screening for fasting glucose, A1C, and other metabolic markers, especially in patients with chronic inflammatory conditions. - Age Recommendations: General screening for diabetes starts at age 35, earlier if there are additional risk factors. 5. Diet and Exercise: - Exercise: Improves insulin sensitivity, and lowers glucose levels. Even moderate activity is beneficial. - Diet: In general, focus on weight loss. A Mediterranean diet rich in whole foods, lean meats, and low in processed foods is recommended. - Overall Health: Weight loss is crucial, but a balanced diet also promotes long-term cardiovascular and metabolic health. Conclusion The podcast emphasizes the complex interplay between inflammation, insulin resistance, and cardiovascular health. Early screening and lifestyle modifications, including diet and exercise, are crucial in managing these conditions and improving patient outcomes.