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Types A & B Insulin Resistance--please don't make me Google

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Anyone care to share a bit of what you know / have heard about the following?



Type A Insulin Resistance

Type B Insulin Resistance

also, Rabson Mendenhall syndrome

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Two major variants of insulin receptor abnormalities associated with acanthosis nigricans have been described—the classic type A insulin resistance syndrome, which is due to an absent or dysfunctional receptor, and type B insulin resistance syndrome, which results from autoantibodies to the insulin receptor. Both syndromes are associated with hyperinsulinemia. Hypoglycemia may still occur in some individuals with insulin resistance syndrome because of an agonist effect of autoantibodies on the insulin receptor. In some patients with insulin-binding antibodies, hypoglycemia may occur when insulin dissociates from the antibodies several hours after a meal.


# Type A syndrome



* Patients are usually tall and have features of hirsutism and abnormalities of the female reproductive tract related to hyperandrogenism (eg, polycystic ovary disease).

* The patient may have either a thin or a muscular body build.

* Acral enlargement, a form of pseudoacromegaly, is not uncommon.


# Type B insulin resistance (autoantibodies to the insulin receptor): Patients usually have symptomatic diabetes mellitus, although ketoacidosis is unusual. Patients occasionally present with hypoglycemia. Agonist activity (hypoglycemia) or antagonist effect (insulin resistance) can occur, depending on the site of binding to the insulin receptor.

# Other insulin-resistant states



* Leprechaunism - Elfin appearance of the face, hirsutism, lack of subcutaneous fat, and thickened skin

* Lipodystrophic states - Variable phenotypic expression (Features include total or partial lack of adipose tissue, metabolic dysfunction such as abnormal glucose homeostasis, hypertriglyceridemia, and increased metabolic rate.)

* Werner syndrome - Cataract, atrophic skin, and early osteopenia

* Rabson-Mendenhall syndrome - Dystrophic nails, dental dysplasia, and acanthosis nigricans

* Pineal hypertrophic syndrome - Early dentition with malformed teeth, hirsutism, thick nails, and skin dryness

* Alstrom syndrome - Retinal degeneration that results in blindness, nerve deafness, hypogonadism (males)

* Ataxia telangiectasia - Cerebellar ataxia, oculocutaneous telangiectases, immune deficiency, and increased proneness to pulmonary infections

* Myotonic dystrophy - Weakness of limb and cranial muscles, cataract



What I've read so far has left me a bit confused. Type A typically occurs in younger patients, and Type B is rare and occurs more frequently in older women. I guess these are two of many types of insulin resistance.


I'd like to learn more about these things too. You know, in "plain English" so I don't have to go to med school to understand it enough to make practical and effective lifestyle decisions.

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