Insulin resistance: unsolved issues of harm and use

Insulin resistance, diagnosed in more than half of cardiac patients, is considered to be a negative factor contributing to further exacerbation of existing metabolic disorders and the progression of cardiovascular diseases (CVD). However, recently, scarce data emerged suggesting that about a quarter of obese people have a favorable prognosis of CVD. These data allowed us to make an assumption that insulin resistance in high-risk patients may represent some kind of a protective mechanism that prevents damage to the organs and tissues of the cardiovascular system. This review discusses the potential protective mechanisms of insulin resistance and the possibilities of their clinical use in choosing the treatment tactics in patients with obesity, type 2 diabetes mellitus, and poorly controlled glycemia.