[Metabolic syndrome-x at the turn of the millennium (Theoretical aspects with practical consequences)]

The authors give an overview on the hypothesis of the metabolic syndrome-x in accordance with insulin resistance and hyperinsulinism in triggering the development of type 2 diabetes mellitus with its clinical complexity. Dealing with the criticism of the original hypothesis, they touch the problem of protein-insufficient feeding in utero and consequences later in life. They discuss the recently emerging importance of postprandial hyperglycaemic condition, which might be even more responsible in leading to atherosclerotic lesions than the hyperinsulinism itself. Finally, they deal with the non-pharmacological intervention and drug therapy as well. A short overview of the results of the UKPDS (United Kingdom Prospective Diabetes Study) are also given, pointing out the clinical importance of correct antihyperglycaemic and antihypertensive treatment. The authors emphasise the utmost importance of early prevention in behalf of avoiding type 2 diabetes and cardiovascular complications as well.