Insulin Resistance Insulin Resistance

Progression to Diabetes

Hypertension: BP >140/90Dyslipidemia:

◦TG >150 mg/dL (1.7 mmol.L)◦HDL-C <35 mg/dL (0.9 mmol/L)

Obesity (central): BMI >30 kg/M2◦Waist girth > 94 cm (37 inch)◦Waist/Hip ratio > 0.9

Impaired Glucose Handling: IR, IGT or DM◦FPG >110 mg/dL (6.1 mmol/L)◦2 hr. PG >200 mg/dL (11.1 mmol/L)

InflammationInflammation

Stage 1 – Early Insulin ResistanceStage 1 – Early Insulin Resistance

Stage 1 – Early Insulin ResistanceStage 1 – Early Insulin Resistance

Treatment recommendations for Stage 1

Stage 2 – Elevated InsulinStage 2 – Elevated Insulin

Graphrepresentspatient's stageof pre-diabetes.

Treatment recommendations for Treatment recommendations for stage 2stage 2

Stage 3: Beta-Cell DysfunctionStage 3: Beta-Cell Dysfunction

Graph represents patient's stage of pre-diabetes.

Treatment recommendations for Treatment recommendations for stage 3stage 3

Inflammation MarkersInflammation MarkersHigh-sensitivity C-Reactive Protein (hs-CRP)High-sensitivity C-Reactive Protein (hs-CRP)

High hs-CRP associated with:Chronic inflammatory state.Insulin resistance (independent of obesity) and increased risk of type 2 diabetes.

Hypertension, metabolic syndrome, and aging.

Increased risk of coronary artery disease, peripheral artery disease, and increased risk of cardiac death in individuals with previous heart attack.

Treatment Options to reduce hs- CRP:Treatment Options to reduce hs- CRP: