ABSTRACT
Insulin resistance is tissue resistance to insulin
action, whether this is in terms of glucose or
lipid metabolism, or the vasodilatory actions
of insulin. Insulin resistance is usually
accompanied by hyperinsulinaemia. Insulin
promotes smooth muscle cell proliferation and
arterial lipid deposition, and hence may be
Insulin resistance has conventionally been
defined as the change in glucose elimination
rate elicited by a unit change in insulin
concentration. It is difficult to quantitate, and
only two methods used in clinical practice
provide a true measure of insulin sensitivity
(the inverse of insulin resistance).9 These are
the euglycaemic hyperinsulinaemic clamp and
the minimal model analysis of glucose and
insulin profiles obtained during an
intravenous glucose tolerance test (IVGTT),
and the two methods correlate closely with
each other.10 The euglycaemic
hyperinsulinaemic clamp utilizes a constant
intravenous infusion of insulin and a varying
intravenous infusion of glucose. Though it
gives a true estimate of insulin sensitivity, the
method is extremely labour intensive and time
consuming, and it is also non-physiological.
