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Guidelines issued on insulin resistance syndrome. (Early Detection, Lifestyle Changes Urged).
WASHINGTON -- Detection and treatment of insulin resistance syndrome need to become a routine part of preventive medical care, experts said at a meeting of a task force on the syndrome.
The first set of clinical practice guidelines on the topic, issued by the American Association of Clinical Endocrinologists and the American College of Endocrinology, requires a proactive patient evaluation to detect this sometimes subtle disorder that affects as many as one in three American adults.
"This is a disorder that, if recognized and dealt with early, can prevent very serious illnesses that we all pay for," said Dr. Daniel Einhorn, medical director of the Scripps Whittier Institute for Diabetes, La Jolla, Calif The tests and interventions for insulin resistance syndrome are low tech and readily available.
First identified in the 1980s by Dr. Gerald Reaven of Stanford (Calif.) University; insulin resistance syndrome describes a cocktail of medical problems that affect insulin-resistant or hyperinsulinemic people. Also known as "dysrnetabolic syndrome" or "syndrome X," insulin resistance syndrome is separate from diabetes or prediabetes, but people with insulin resistance syndrome are at increased risk for developing type 2 diabetes and cardiovascular disease.
Insulin response varies about tenfold between the most insulin-sensitive and the most insulin-resistant person in the general population, said Dr. Reaven, who cochaired the task force with Dr. Einhorn. At least half of that variability relates to how overweight or sedentary a person is.
"We are now in a position to identify these individuals with some degree of accuracy," Dr. Reaven said. Physicians can then intervene earlier with their patients to try to prevent diabetes, coronary heart disease, and other chronic diseases.
Doctors already know that lifestyle improvements (losing 5%-10% of body weight, walking for 15-20 minutes 5 days per week, taking the stairs rather than elevators) can reduce the risk of developing insulin resistance syndrome and related health problems. Identifying a medical reason to help prod patients into lifestyle changes increases the odds that they will do so, Dr. Einhorn commented.
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