title: Insulin levels in insulin resistance: phantom of the metabolic opera?
abstract: Insulin resistance is considered a core component in the pathophysiology of the metabolic syndrome. Some clinicians measure serum insulin concentrations in the mistaken belief that they can be used to diagnose insulin resistance. Serum insulin levels are poor measures of insulin resistance. Furthermore, there is no clinical benefit in measuring insulin resistance in clinical practice. Measurements of fasting serum insulin levels should be reserved for large population-based epidemiological studies, where they can provide valuable data on the relationship of insulin sensitivity to risk factors for diabetes and cardiovascular disease. Clinicians should shift from identifying "insulin resistance" to identifying risk factors, such as fasting glucose and lipid levels, hypertension and central obesity. These proven risk factors converge within the metabolic syndrome. Individuals "at risk" of diabetes and atherosclerotic cardiac disease can be identified simply and inexpensively, using classic clinical techniques, such as history-taking, physical examination, and very basic investigations.
authors.affiliation: Diabetes and Obesity Program, Garvan Institute of Medical Research, Sydney, New South Wales. k.samaras@arvan.org.au
authors.forename: Katherine
authors.initials: K
authors.lastname: Samaras
authors.forename: Aidan
authors.initials: A
authors.lastname: McElduff
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Twigg
authors.forename: Joseph
authors.initials: J
authors.lastname: Proietto
authors.forename: John B
authors.initials: JB
authors.lastname: Prins
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Welborn
authors.forename: Paul
authors.initials: P
authors.lastname: Zimmet
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Chisholm
authors.forename: Lesley V
authors.initials: LV
authors.lastname: Campbell
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology*; D012307:Risk Factors
chemical_list: D007328:Insulin