ABSTRACT
One of the main risk factors for Type 2 diabetes in the Indo-Asian is the insulin resistance syndrome with central obesity, hyperinsulinaemia, high triglycerides and low HDL-cholesterol. When prescribing highly purified animal insulin, the prescriber should consider the religious needs and cultural values of the patient. Type 2 diabetes is a chronic progressive disorder of metabolism characterised by defects of insulin secretion and utilisation. G. M. Reaven proposed in his Banting lecture that these features were related to hyperinsulaemia and postulated the 'Syndrome X' hypothesis. Maternal hyperglycemia, particularly in late pregnancy, leads to neonatal beta-cell hyperplasia while malnutrition, particularly in rats, causes permanent reduction of the beta-cell mass. It has long been recognised that cardiovascular risk factors, which include Type 2 diabetes, hypertension, dyslipidaemia and central obesity can co-exist in the same patient. Blood pressure should be brought below 140/80 mmHg using angiotensin-converting enzyme inhibitors as first-line therapy.
