Insulin resistance syndrome. A review

Insulin is a hormone and a growth factor that elicits a myriad variety of metabolic and mitogenic cellular actions. Insulin resistance (IR) could occur with any of the effects of insulin, even though it usually refers to its ability to stimulate glucose uptake in insulin-sensitive peripheral tissues such as fat and muscle. IR as it applies to the glucose-insulin relationship is distinctly different from the clinical concept of an IR syndrome, which applies to a cluster of metabolic disorders (type 2 diabetes mellitus [T2DM], central obesity, dyslipidemia, hypertension, increased prothrombotic and antifibrinolytic factors/ hypercoagulability and a predilection for heart disease). The rising obesity epidemic portends great significance, as it is associated with a high prevalence of IR. We review the etiopathogenesis of IR, the clinical spectrum, and review the clinical data on the management of IR.