Insulin resistance is associated with type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), both independently and in association with the insulin resistance syndrome. Decreased insulin sensitivity has been documented in those known to be at risk for T2DM, such as normoglycaemic first-degree relatives of patients with T2DM, or women with history of gestational diabetes. It is now well established that generalized obesity and abdominal obesity (excess subcutaneous and intra-abdominal fat) are associated with insulin resistance. Other important factors contributing to insulin resistance include accumulation of hepatic fat and intra-myocellular lipids, both of which can exist independent of generalized adiposity.
In most people with T2DM, insulin resistance is generally present for many years before the diagnosis. Despite possible influences from genetic and perinatal factors, diet and physical activity are likely to have greater and often overriding influence in pathogenesis of the insulin resistance syndrome and T2DM.