Insulin resistance

The possible causes of insulin resistance, in particular the production of insulin-antibodies, abnormal factors interfering with the effect of insulin on peripheral tissues and the Somogyi effect, are discussed. Accumulation of insulin antibodies with formation of insulin-antibody complexes is pointed out as the prevalent cause of insulin resistance in advanced age. Intravenous insulin treatment with massive doses ensured a beneficial effect. Achrestic diabetes associated with peripheral resistance is regarded as the cause of insulin resistance in juvenile patients possessing no major amounts of antibody. Muscle tissue obtained from these patients showed an insulin resistant impairment of glucose consumption and of Na-transport. This is consistent with the peripheral pathomechanism underlying this condition. A feedback mechanism elicited by latent hypoglycaemia may be the cause of spurious insulin resistance.