Abstract
Resistance to insulin was first described more than 60 years ago, whensome patients with diabetes were noted to be less sensitive to insulintreatment than others.1 The development of the radioimmunoassay(RIA) technique for the measurement of insulin by Berson and Yalowstarted the modern study of insulin resistance in man. Insulin resis-tance describes an impaired biological response to insulin.2 It hasbeen broadly defined as ‘a state (of a cell, tissue, or organism) inwhich a greater than normal amount of insulin is required to elicit aquantitatively normal response’.3,4 However, insulin resistance can beselective – i.e. involving only certain aspects of insulin action – a factthat complicates both the definition and its characterization in vivoand in vitro.5 This chapter will focus on the clinical effects of insulinresistance on type 1 diabetes, its role in obesity and type 2 diabetes,and possible ways of modifying insulin resistance. The underlyingpathophysiology of insulin resistance and in-vivo assessment ofinsulin sensitivity will also be discussed.
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