Insulin resistance syndrome, pre-diabetes, and the prevention of type 2 diabetes mellitus

Insulin resistance syndrome (IRS), also known as the metabolic syndrome, is now well recognized as a distinct pathological and clinical entity, with multiple significant ramifications for both the high-risk individual as well as the public health system. The primary contributory cause is obesity. Common manifestations associated with IRS may include atherosclerotic heart disease, hypertension, impaired glucose tolerance, dyslipidemia, polycystic ovary syndrome, and hypercoagulability. This review will present the features associated with the disorder, the accepted clinical diagnosis, available and potential treatment modalities, and ongoing or completed trials which suggest that progression from IRS to type 2 diabetes mellitus and early coronary heart disease may be prevented in adolescents and adults.