[Insulin resistance: a frequent phenomenon in clinical practice]

This review is focused on the diagnostic, clinical and therapeutic aspects of insulin resistance relevant to the clinician. The observed phenomenon of the wide variability of insulin sensitivity in clinically healthy subjects is discussed; qualitative and quantitative aspects of the methodologies currently used for the assessment of insulin sensitivity in the clinical setting are dealt with, as well as their applicability to day-to-day clinical care. The medical consequences of hyperinsulinemia, including dyslipidemia, hypertension coronary artery disease and ovarian hyperandrogenism are likewise discussed. A panoramic view of the various clinical presentations of insulin resistance is also offered, including clinical elements for suspicion, as well as an account of the prevalent, less-prevalent and rare disorders harboring the phenomenon of insulin resistance. The final topic of the review is a novel discussion on the therapeutic possibilities in insulin resistance disorders, including treatment with hormones and antihormones.