Key result
Insulin resistance as a primary driver of diabetes was first proposed ~70 years ago.
Introduces the historical origins and conceptual foundation of insulin resistance as a causal factor in type 2 diabetes mellitus and cardiovascular disease.
Historical diabetes mechanism insights may refine CV risk models; leaves open prospective validation in contemporary cohorts.
n his 1939 Goulstonian Lectures to the Royal College of Physicians in London, Harold Himsworth addressed the "Mechanisms of Diabetes."In the course of these 3 presentations, 1-3 he provided evidence that "diabetes mellitus is a disease in which the essential lesion is a diminished ability of the tissue to utilize glucose.The high blood sugar is a controlled and compensatory phenomenon, the object of which is to facilitate the utilization of glucose by the tissues."In addition, he challenged the conventional wisdom that "all causes of human diabetes could be explained by deficiency of insulin" and went on to utter the heretical notion that "a state of diabetes might result from inefficient action of insulin as well as from a lack of insulin."Thus, the notion of a causal role of insulin resistance in human disease was born almost 70 years ago.
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Gerald M. Reaven (2005) conducted a review in Insulin resistance, type 2 diabetes mellitus, and cardiovascular disease. Insulin resistance was evaluated. Insulin resistance as a causal factor in human diabetes mellitus—resulting from inefficient insulin action rather than solely insulin deficiency—was first proposed nearly 70 years ago in 1939.
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