Education And Debate

Fortnightly Review: Insulin resistance

BMJ 1996; 313 doi: (Published 30 November 1996) Cite this as: BMJ 1996;313:1385
  1. Andrew J Krentz, consultant physiciana
  1. a Diabetes Resource Centre, Royal South Hants Hospital, Southampton SO14 0YG
  • Accepted 17 October 1996


Summary points

  • Insulin resistance is a state in which normal concentrations of insulin produce a subnormal biological response

  • Patients with insulin resistance have hyperinsulinaemia together with normoglycaemia or hyperglycaemia

  • Insulin resistance is commonly associated with obesity, non-insulin dependent diabetes mellitus, and essential hypertension

  • The insulin resistance syndrome includes impaired insulin stimulated glucose uptake, hyperinsulinaemia, glucose intolerance, hypertension, and dyslipidaemia

  • Drugs such as corticosteroids, ß blockers, and high dose thiazides can exacerbate insulin resistance; angiotensin converting enzyme inhibitors and (alpha) blockers may reduce resistance

  • Reducing insulin resistance is important in managing non-insulin dependent diabetes—for example, by losing weight, aerobic exercise, and stopping smoking; moderate alcohol consumption improves insulin resistance

  • Metformin improves multiple aspects of the insulin resistance syndrome. Novel insulin action enhancing drugs including the thiazolidinediones are under evaluation


  • Conflict of interest None.

  • Accepted 17 October 1996
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