What is the prognosis of insulin resistance?

Updated: Aug 07, 2019
  • Author: Samuel T Olatunbosun, MD, FACP, FACE; Chief Editor: George T Griffing, MD  more...
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Answer

Prognosis depends on the type of insulin resistance syndrome. The prognosis is guarded in regard to many of the disorders related to insulin resistance syndrome early in life. For instance, in leprechaunism, the clinical course is often characterized by growth retardation, abnormal glucose homeostasis (especially occurrence of hypoglycemia), and fatality within the first year of life. In other conditions, progression of insulin resistance and manifestation of related disorders continue into adulthood.

In the metabolic syndrome, the prognosis is often affected by the number and severity of comorbid conditions and by the institution of appropriate therapy. People with the metabolic syndrome are twice as likely to die from, and three times as likely to have, a myocardial infarction (MI) or stroke than are people without the syndrome. They also have a 5-fold increased risk of developing type 2 diabetes.

Insulin resistance is a common basis for development of glucose intolerance, including diabetes and coronary artery disease (CAD).

Diabetes mellitus is the sixth leading cause of death by disease and the seventh leading cause of death in the United States. Globally, up to 80% of the 200 million people with diabetes will die of cardiovascular disease. Diabetes is the leading cause of end-stage renal disease and blindness in the United States. Individuals with diabetes have a much higher risk of heart disease and a higher risk of stroke; they also have a high risk of neuropathy and gangrene. Diabetes is also associated with acute metabolic complications.

CAD is the leading cause of death in the United States and in most developed countries. Coronary artery disease is responsible for 500,000 deaths annually in the United States. Nearly 1.5 million myocardial infarctions, approximately one third of which are fatal, occur annually. The total annual economic cost of CAD in the United States is nearly $60 billion.

Mortality and morbidity related to other conditions associated with insulin resistance include the following:

The availability of newer modalities of treatment specifically targeted at primary and secondary prevention of complications has improved survival and quality of life significantly in patients with insulin resistance syndrome. However, morbidity and mortality rates are still considerable in the general population.


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