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Cite this article
Insulin Resistance: From Benign to Type 2 Diabetes Mellitus
1 The Dorrance Hamilton Research Laboratories, Division of Endocrinology, Diabetes, and Metabolic Diseases, Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA
Rev. Cardiovasc. Med. 2003, 4(S6), 3–10;
Published: 20 November 2003
Type 2 diabetes has become the most frequently encountered metabolic disorder in the world, currently affecting 5% to 10% of most populations, and the incidence continues to grow among developing nations. Two fundamental abnormalities are involved in the pathogenesis of type 2 diabetes: Resistance to the biologic activities of insulin in glucose and lipid metabolism and inadequate insulin secretion from the pancreatic β cells. In genetically predisposed individuals, type 2 diabetes is pathogenically linked with progressive obesity, especially adiposity that is visceral or ectopic in distribution. While microvascular complications (retinopathy, nephropathy, neuropathy) continue to plague patients with longstanding type 2 diabetes, cardiovascular disease has assumed particular importance, accounting for more than 80% of adverse outcomes among patients. Since the aggressive management of diabetes and its complications poses a considerable challenge, large trials to prevent the progression to overt diabetes in persons at high risk have recently demonstrated that lifestyle modification and pharmaceutical therapy can be successful approaches. A better understanding of the complex relationship between obesity and both the development of type 2 diabetes and its cardiovascular complications may provide additional treatment targets in the future to prevent the devastating chronic morbidity of this disorder.
Type 2 diabetes mellitus
Pancreatic ß cells