Gerald M. Reaven, MD: Demonstration of the central role of insulin resistance in type 2 diabetes and cardiovascular disease.

Abstract

Gerald M. Reaven, MD, could easily be epitomized as the “Father of Insulin Resistance.” (For those who do not know Dr. Reaven, he would humbly raise objection to being called Dr. Reaven rather than Jerry.) That said, Jerry is credited with developing the insulin suppression test, the first quantitative method to measure insulin-mediated glucose uptake in humans (1). Using this technique, he established the importance of insulin resistance in human disease, and importantly, in type 2 diabetes (2,3). In nondiabetic individuals, he demonstrated the role of insulin resistance/compensatory hyperinsulinemia in the development of 1 ) hypertriglyceridemia (4) and low HDL concentrations (5), 2 ) decreased urinary uric acid clearance and hyperuricemia (6), 3 ) decreased LDL particle diameter (7), 4 ) enhanced postprandial lipemia and remnant lipoprotein accumulation (8), 5 ) increased levels of plasminogen activator inhibitor-1 (9), 6 ) salt sensitivity (10), 7 ) essential hypertension (11), and 8 ) increased sympathetic nervous system activity (12). In addition to emphasizing the role of insulin resistance/compensatory hyperinsulinemia in increasing the likelihood of an individual developing one or more of the consequences listed above, he first pointed out the clustering of these abnormalities. It is clear now that this group of clinical abnormalities, initially designated Syndrome X, is an important factor leading to cardiovascular disease. Syndrome X was introduced to the medical community in his now famous Banting Lecture in 1988 (13) and only later became known as metabolic syndrome. Jerry was born in Gary, IN, on 28 July 1928, but spent most of his precollege years living in Cleveland, OH, thus accounting for his lifelong allegiance to the Cleveland Indians baseball team and a great deal of frustration on his part during their many less-than-stellar seasons. Jerry matriculated at the University of Chicago and graduated in 1949, also the year of his marriage to his …