Insulin resistance describes a condition that is characterized by decreased tissue sensitivity to the action of insulin, leading to a compensatory increase in insulin secretion. Most people with insulin resistance are able to secrete enough insulin to maintain non-diabetic glucose levels. Some of these people will go on to develop overt Type 2 diabetes. However, the majority, even if they do not develop diabetes, are still at significantly increased risk for heart attack, stroke and other diseases.

"The Insulin Resistance Syndrome is a metabolic disorder that underlies some of the most deadly and costly diseases in the U.S., so early intervention is critical," said Daniel Einhorn, MD, FACE, co-chairman of the ACE/AACE Insulin Resistance Syndrome Task Force and Medical Director of the Scripps Whittier Institute for Diabetes. "As the prevalence of Insulin Resistance Syndrome has skyrocketed 61 percent in the last decade, it is crucial that medical professionals have consistent and definitive criteria to assess this serious condition," he said.

    Conference Findings
    -------------------

The ACE/AACE Insulin Resistance Syndrome Conference extended the concept of the Metabolic Syndrome (NCEP/ATPIII) by:

    1) Addressing the underlying pathophysiology of insulin resistance, which
       leads not only to CVD but also to diabetes and other disorders;

    2) Recognizing additional associated disorders such as polycystic ovary
       syndrome (PCOS), which affects one in ten U.S. women of child-bearing
       age; and non-alcoholic fatty liver disease;

    3) Improving the detection of the Insulin Resistance Syndrome by
       emphasizing the use of the 2-hour post glucose challenge as the most
       sensitive clinically available test for insulin resistance.

Specific emphasis was placed on obesity as a prime modulator of insulin resistance, and a key reason for the epidemic of Insulin Resistance Syndrome. The current epidemic of obesity among children and adolescents puts them at risk for insulin resistance and its complications. Reinforcing the importance of obesity treatment, conferees advocate use of Body Mass Index (BMI) as the best determinant for overweight/obesity in the clinical setting.

This landmark ACE/AACE conference convened from August 25 to August 26 in Washington D.C.

    Insulin Resistance Syndrome Risk Factors
    ----------------------------------------

Following are the key clinical signs of Insulin Resistance Syndrome, as defined by the ACE/AACE task force. These factors, which should be measured in people who are at risk, include:

                            TABLE OF RISK FACTORS

          Components                     Abnormal Parameters
          ----------                     -------------------

          Overweight/obesity             BMI greater than or equal to 25
          High triglyceride levels       Greater than or equal to 150 mg
                                          /dL (1.69 mmol/L)
          Low HDL cholesterol            Less than 40 mg/dL (1.04 mmol/L)
                                          in men
                                         Less than 50 mg/dL (1.29 mmol/L)
                                          in women
          High blood pressure            Greater than or equal to 130/85 mm Hg
          2-hour post glucose challenge  Greater than 140 mg/dl
          Fasting glucose                Between 110mg/dL-126mg/dL

Other risk factors include family history of Type 2 diabetes, hypertension or CVD; polycystic ovary syndrome, sedentary lifestyle, age and ethnicity.

ACE/AACE urges physicians to look carefully at these measures when assessing patients' health status. "By recognizing Insulin Resistance Syndrome there is a greater chance of reducing a patient's risk of developing diabetes and heart disease later in life, which combined affects more than 28 million people nationwide," said Hossein Gharib, MD, FACE, President of AACE.

Participants included leadership from the American Medical Association, The American College of Physicians-American Society of Internal Medicine, the American Diabetes Association, The Endocrine Society, the National Institutes of Health, the Office of the Surgeon General, the Centers for Disease Control and Prevention, and the American Association of Diabetes Educators.

The full text of the panel's statement will be available in draft form following the conference at http://www.aace.com.

Source: The American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE)