Endocrine Abstracts

Insulin resistance is usually taken to mean a state in which insulin exerts a diminished blood glucose lowering effect. Insulin resistance is not a disease in itself, but is closely associated with pandemic diseases or tissue pathologies including type 2 diabetes, fatty liver, metabolic dyslipidemia, polycystic ovary syndrome and some cancers. It is also closely associated in the general population with obesity, and there is a widely prevalent view that obesity leads to insulin resistance, and that it is when compensatory hyperinsulinaemia starts to fail that diseases ensue. Nevertheless the idea has been promulgated since the 1980s that major components of the ‘insulin resistance syndrome’ are actually consequences of high levels of insulin exerting harmful effects on responsive tissues. In this talk known single gene forms of insulin resistance will be compared and contrasted with prevalent insulin resistance and with insulin deficiency in order to assess the relative importance in humans of lack of insulin action and, conversely, excessive insulin action in disease pathogenesis, with particular reference to fatty liver, dyslipidaemia, polycystic ovary syndrome and soft tissue overgrowth.