ABSTRACT
Insulin resistance is a cardinal underlying mechanism in the pathogenesis of chronic disease states. In many cases, insulin resistance results from adaptive responses in efforts to promote survival under circumstances of scarce energy availability. The perspective of mitochondrial function in the clinical approach to diabetes has been a crucial missing piece. There are currently a few drugs that may be used to help restore mitochondrial function in the treatment of diabetes and other metabolic disorders. Whole-body energy homeostasis is regulated by the coordination between food intake and energy expenditure. It is well established that glucose and fatty acids are major sources of energy, therefore maintaining optimum glucose and lipid levels in the blood is critical for survival. Obesity has been recognized as a component of the insulin-insensitive adult form of diabetes, going back to Himsworth in 1939. Reactive oxygen species and reactive nitrogen species, or free radicals of oxygen- and nitrogen-containing molecules, can cause oxidative and nitrosative stress respectively.
