Insulin resistance

impairment of the normal response of muscle and other cells to endogenous or exogenous insulin, often complicating the deficiency of endogenous insulin that is characteristic of type 2 diabetes mellitus

Description
Insulin resistance is a peripheral phenomenon and can occur even when the quality and quantity of insulin produced by the pancreas are normal. It apparently results from a decrease in the number of insulin receptor sites on cells, a malfunction of the biochemical glucose transport system, or both. Insulin resistance is often associated with high levels of circulating antibody to insulin receptors. The phenomenon of insulin resistance explains why some people with type 2 diabetes have hyperinsulinemia in the fasting state, often coexisting with elevated plasma glucose levels. Insulin resistance correlates closely with obesity in diabetes. It occurs less frequently in lean diabetics, whose principal problem is usually primary failure of insulin production. Insulin resistance is often seen in persons with or without frank diabetes who have other endocrine or systemic disorders, including dyslipidemias, hypertension, hyperuricemia, and chronic infection. Some women with polycystic ovaries, hirsutism, and anovulation also have insulin resistance and hyperinsulinemia. Troglitazone, a newer agent used in the treatment of type 2 diabetes mellitus, improves insulin sensitivity.