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An Epidemic of the Times: Physicians Urged to Monitor for Insulin Resistance Syndrome

A committee of experts from the American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) reports that as many as one in three Americans have Insulin Resistance Syndrome, or pre-diabetes – a condition that can lead to type 2 diabetes, heart disease, and stroke.

Insulin resistance, according to the AACE, is a condition characterized by decreased tissue sensitivity to the action of insulin. This leads to a compensatory increase in insulin secretion.

“The Insulin Resistance Syndrome is a metabolic disorder that underlies some of the most deadly and costly diseases in the United States, so early intervention is critical,” says Daniel Einhorn, MD, FACE, co-chair of the ACE/AACE Insulin Resistance Syn-drome 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.”

Key clinical signs of Insulin Resistance Syndrome, as defined by the ACE/AACE task force, include the following:

  • Body mass index of 25 or greater
  • Triglyceride levels of 150 mg/dl or greater
  • HDL cholesterol less than 40 mg/dl in men and less than 50 mg/dl in women
  • Blood pressure 130/85 mm or higher
  • Blood-glucose level of 140 mg/dl or greater after a two-hour 75-gram oral glucose challenge test
  • Fasting blood glucose between 110 and 125 mg/dl

Other risk factors include a family history of type 2 diabetes, hypertension or cardiovascular disease; a sedentary lifestyle; non-Caucasian ethnicity; increasing age; and a personal history of cardiovascular disease, polycystic ovary syndrome or gestational diabetes. In addition, waist circumference greater than 40 inches in men and 35 inches in women is a risk factor, as is the skin condition acanthosis nigricans.

The ACE/AACE urges physicians to look carefully at these measures when assessing patients’ health status.

The full text of the panel’s statement is available at www.aace.com.

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