Insulin-resistance in paediatric age: Its magnitude and implications

Table 1 Various types of insulin resistance in children

IR type	Description
Partial IR	The impairment of insulin receptor expression is limited to specific tissue and consequently exhibits some features of insulin resistance according to the tissue affected
Complete IR	The impairment of insulin receptor expression is extensively distributed all over the body tissues and organs with the full expression of the syndrome
IR syndrome type A	It is a rare type of hereditary insulin resistance syndrome due to the lack of response of the tissues to the insulin. Patients with this syndrome are nonobese and demonstrate severe hyperinsulinemia, hyperandrogenism, and acanthosis nigricans. The clinical features are more severe in affected females than in males, and they mostly become apparent at the age of puberty
IR syndrome type B	It is a rare disorder caused by autoantibodies to the insulin receptor. This disorder is most frequently reported in middle-aged black women and is invariably associated with other autoimmune diseases
Compensated IR	The resulting hyperinsulinemia compensates for the body's metabolic needs and prevents metabolic derangement
Non-compensated IR	There is a progressive failure of compensatory hyperinsulinemia to fulfill the body's metabolic needs through puberty with rising blood glucose and triglyceride levels and metabolic derangement
Early childhood IR	Onset before the age of ten, a metabolic syndrome diagnosis cannot be made, but further measures should be taken if one of the parents has metabolic syndrome, DM type-II, dyslipidemia, cardiovascular risk factors, hypertension, or obesity
Late childhood IR	Onset after ten years of age, diagnosis of metabolic syndrome can be made
Social IR	It is a negative attitude directed towards avoiding or rejecting insulin therapy by some social groups

DM: Diabetes mellitus; IR: Insulin resistance.