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Mechanism

Insulin

Anabolic hormone produced in pancreatic β cells that allows glucose to enter cells. Its chronic dysregulation (insulin resistance) is the axis of metabolic syndrome, prediabetes, and type 2 diabetes, with effects on the brain as well (Alzheimer's has been called 'type 3 diabetes').
Category
Scientific evidence
Very high
Number of findings
4
Sources
Our own summaries · Cited studies

Regulatory status

Approved (FDA / EMA)

FDA (U.S.): Approved: the first was Humalog (insulin lispro, June 1996); Lantus (insulin glargine, April 20, 2000) was the first basal analog; Awiqli (insulin icodec, weekly) approved in March 2026 only for adults with type 2 diabetes.

EMA (EU): Approved: Humalog (April 30, 1996) and successive rapid-acting and basal analogs; Awiqli (insulin icodec, May 17, 2024) for adults with type 1 and type 2 diabetes (in type 1, combined with prandial insulin).

Differences between women and men

Insulin needs change during pregnancy, and poorly controlled diabetes in pregnancy increases the risk of ketoacidosis, preeclampsia, and malformations; published studies with insulin glargine do not show a clear relationship with developmental adverse effects (FDA label for Lantus). The dose is adjusted individually.

Effect by goal · level of evidence

Glucose homeostasis

regulates Very high physiology (A)
Metabolic basis

Allows glucose to enter muscle and fat after meals. Its absolute deficiency is type 1 diabetes; its functional deficiency due to resistance is type 2 diabetes.

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Metabolic syndrome and prediabetes

dysregulates Very high physiology (A)
Key marker

Chronic resistance precedes diabetes by 5-10 years. HOMA-IR, HbA1c, fasting glucose, and basal insulin levels are available clinical markers.

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Fat storage

promotes Very high physiology (A)
Basis of storage

Chronically high insulin blocks lipolysis and promotes fat storage. It is one of the bases of why reducing insulin spikes (lowering glycemic index, fasting) facilitates weight loss.

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Brain and Alzheimer's (type 3 diabetes)

modulates Moderate cohorts (AA)
New pathway in dementia

Brain insulin resistance participates in the pathophysiology of Alzheimer's. Ketogenic diet and intermittent fasting show a signal in mild cognitive impairment.

View the study (review) →

Information, not medical advice. Scientific evidence reflects the quality of the studies.

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