ABSTRACT
In general, the clinical condition of diabetes arises in one of two ways. Type 1 diabetes appears in childhood, with a sudden and potentially catastrophic decline in the ability of the pancreas to secrete insulin. Type 2 diabetes, on the other hand, emerges later in life out of a continuum of metabolic disturbances that may have been present for many years before the pancreatic insulin response to glucose begins to decline and symptoms of diabetes appear. This continuum of metabolic disturbances has been a topic of growing interest since 1988 when Reaven1 brought its features together in the unifying concept of an insulin resistance or metabolic syndrome.
