[Insulin resistance. Frequently administration errors are the source]

The term insulin resistance includes both physiological and pathological metabolic changes. Physiological insulin resistance, for example, is to be found in puberty or in advanced old age; additionally, it may be caused by endocrinological diseases. A pathologically elevated insulin requirement is to be found in the insulin resistance syndrome, type A (genetic) or type B (insulin receptor antibodies). In recent times, however, a massively elevated insulin requirement has been observed in increasing numbers of type 2 diabetics, in whom a subcutaneous insulin resistance is suspected--a condition that can be verified by various tests. The treatment of choice for breaking down this resistance is the intravenous administration of sufficiently high-dosed insulin that is as closely matched to the sugar profile as possible. In many cases the return to subcutaneous insulin--which again must be adequately high dosed--becomes possible during the further course of the disease. In addition, a case of insulin resistance caused by patient manipulation is described.