Peer-reviewed article
Insulin Resistance in Children
Veronica Maria Tagi, Cosimo Giannini, Francesco Chiarelli ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a review of insulin resistance in children, covering its causes, measurement techniques, and treatment approaches. The document discusses the association between insulin resistance and obesity, type 2 diabetes, and metabolic syndrome in children and adolescents. It examines diagnostic methods and outlines lifestyle and pharmacological intervention options. The review synthesizes current medical knowledge but does not evaluate the effectiveness of any specific intervention.
Key points
- Insulin resistance is strongly associated with obesity in children and adolescents, and linked to increased prevalence of type 2 diabetes and metabolic syndrome
- Early diagnosis and prevention of type 2 diabetes while glycemia is normal is emphasized as fundamental
- The hyperinsulinemic euglycemic clamp is the gold standard for measuring insulin resistance but is costly and difficult to perform
- Treatment focuses first on lifestyle interventions, with pharmacological intervention considered in selected cases
- Insulin resistance can also result from corticosteroids, growth hormone therapy, and genetic diseases
Limitations
This is a narrative review synthesizing existing knowledge rather than conducting new research or evaluating an intervention. It does not provide empirical data on the effectiveness of specific prevention or treatment strategies for insulin resistance in children.
Abstract
Insulin resistance (IR) is a pathological condition strongly associated with obesity. However, corticosteroids or growth hormone therapy and genetic diseases may affect insulin sensitivity lifelong. In obese children and adolescents of any age there is an evident association between IR and an increased prevalence of type 2 diabetes (T2D) and other elements contributing to the metabolic syndrome, leading to a higher cardiovascular risk. Therefore, early diagnosis and interventions in the attempt to prevent T2D when glycemia values are still normal is fundamental. The gold standard technique used to evaluate IR is the hyperinsulinemic euglycemic clamp, however it is costly and difficult to perform in clinical and research sets. Therefore, several surrogate markers have been proposed. Although the treatment of insulin resistance in children is firstly targeted to lifestyle interventions, in selected cases the integration of a pharmacological intervention might be taken into consideration. The aim of this review is to present the current knowledge on IR in children, starting with an outline of the recent evidences about the congenital forms of deficiency in insulin functioning and therefore focusing on the physiopathology of IR, its appropriate measurement, consequences, treatment options and prevention strategies.