Mechanisms of insulin resistance in non-insulin-dependent (type II) diabetes.

Characteristic of both obesity and non-insulin-dependent diabetes mellitus, insulin resistance is triggered at the level of the target tissue and can be induced by three general categories of causes: (1) an abnormal beta cell secretory product, (2) circulating insulin antagonists, or (3) a target tissue defect in insulin action. Decreased numbers of insulin receptors and a post-receptor defect in insulin action both play relative roles in insulin resistance. A general trend, however, indicates that as insulin resistance increases, the post-receptor defect becomes more prominent. Impaired glucose uptake and subsequent increased hepatic glucose oxidation in non-insulin-dependent diabetes mellitus are major contributing factors to fasting hyperglycemia.