Introduction
as well as of the economic cost for the health care system. 4 To minimize this burden we first need Insulin resistance is a condition of reduced to understand the cause(s) and the response to a given amount of insulin. Since mechanism(s) of insulin resistance and, secinsulin exerts pleiotropic effects in target ondly, to treat it. Many studies have been cartissues, insulin resistance may theoretically ried out in humans in the last 20 years to regard any one (or more than one) of these deal with this problem; however, the molecular involve. However, from a clinical point of view defects of insulin action that are responsible for insulin resistance refers to an impaired insulin human insulin resistance remain unknown. 3,5 effect on glucose uptake and metabolism which This failure is mainly due to the following under physiological conditions occurs mainly reasons: at the level of muscle (Ͼ80%) and adipose (about 5-10%) tissue. 1,2 This condition plays a (i)
Incomplete understanding of insulin key role in the pathogenesis of non-insulinmechanism of action (it is difficult to dependent diabetes mellitus (NIDDM) and is understand why insulin is not effective associated with a variety of other disorders when its mechanism of action is including obesity, polycystic ovarian disease, unknown). The great improvement in essential hypertension, dyslipidaemia our understanding of insulin action (hypertriglyceridaemia and low high-density acquired in very recent years suggests lipoprotein (HDL) cholesterol) and coronary a likely solution to this problem in the artery disease (CAD). [1][2][3] As a consequence, near future. insulin resistance has a tremendous deleterious (ii) Heterogeneity of insulin resistance, in impact in terms of duration and quality of life terms of both causal molecular defects 5 and insulin target tissues affected by the disorder. 2,6 (iii) Selection of the subjects to be studied.
q Recipient of a Juvenile Diabetes Foundation This is for two different reasons: (a) as post-doctoral fellowship.
a matter of fact, most studies on human insulin resistance have been carried out