Cellular alterations responsible for insulin resistance in obesity and type II diabetes mellitus.

Numerous studies in animals and man have demonstrated that insulin resistance is a prominent feature in both obesity and type II diabetes mellitus. Considerable work over the past decade has provided us with a clearer understanding of the pathophysiology of these insulin resistant states. Although some alterations responsible for insulin resistance have been identified, the factors that mediate these undesirable changes are still unknown. Recent evidence demonstrates that improving blood sugar levels by conventional means at least partially corrects both the insulin resistance and relative insulin deficiency of type II diabetes mellitus. Thus, future efforts should be directed towards a clearer understanding of pathophysiology and more efficacious methods of achieving metabolic control.