THE ROLE OF TROGLITAZONE IN TREATING THE INSULIN-RESISTANCE SYNDROME

Insulin resistance is characterized by impaired responsiveness to endo genous or exogenous insulin and often results in the insulin resistanc e syndrome, a clustering of cardiovascular risk factors that includes abdominal obesity hypertension, dyslipidemia, glucose intolerance, and hyperinsulinemia. Although the mechanism responsible for insulin resi stance has not been completely defined, it is likely due to defective insulin receptor signaling and results in decreased use of glucose. Tr oglitazone, the first in a new class of drugs, directly decreases insu lin resistance by improving insulin-mediated glucose disposal and redu ces plasma insulin concentrations. Glycemic control achieved with trog litazone monotherapy is equivalent to that with sulfonylurea and metfo rmin, and when combined with these agents offers additional plasma glu cose reduction. Studies are necessary to determine the effect of thiaz olidinediones on morbidity and mortality of patients with type 2 diabe tes and insulin resistance.