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April 10, 2018

When we talk to patients about prediabetes, one of the topics of discussion is likely to be about insulin resistance. However, what we are usually describing is glucose resistance. The lecture usually goes something like this: “If you eat too much sugar, then your cells get filled with the sugar …

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #120: The Insulin Resistance Syndrome Part 1

What is insulin resistance? Broadly, insulin resistance can be defined as an abnormal biologic response to insulin; insulin, whether endogenous or exogenous in origin, has limited ability to reverse a hyperglycemic metabolic state.Thus a person with insulin resistance is, almost inevitably, progressing towards developing frank type 2 diabetes (T2DM) if an intervention (usually lifestyle) is not implemented. Due to the very close link between diabetes and insulin resistance, no formal clinical definition of insulin resistance has emerged.We will discuss the potential clinical use of the insulin resistance syndrome and the metabolic syndrome later in the chapter. For now, we focus on investigation of insulin resistance as a useful entity for research concepts, and in particular discuss its biologic consequences by describing its associated risk factor perturbations.

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