OBJECTIVE -To identify a reliable yet simple indirect method for detection of insulin resistance (IR).RESEARCH DESIGN AND METHODS -A total of 65 subjects (44 men and 21 women aged 30 -60 years) were selected by a simple random sampling method. Inclusion criteria were voluntary participation from staff and hospital personnel, absence of abnormal glucose tolerance, and normal results of lipid profile and basic blood chemistry. A blood sample was taken after a 12-h overnight fast to determine plasma lipid, glucose, and insulin levels. An intravenous glucose tolerance test with administration of insulin after 20 min and extraction of multiple blood samples for glucose and insulin measurements and calculation of the minimal model approximation of the metabolism of glucose (MMAMG) S i value were performed. Three indirect indexes used to predict insulin sensitivity or IR were calculated, and metabolic syndrome was diagnosed using the Adult Treatment Panel III (ATP III) criteria. All results were correlated with those of the MMAMG.RESULTS -The 75th percentile value as the cutoff point to define IR corresponded with a fasting plasma glucose level of 12 mU/l, a homeostasis model assessment of 2.6, a 25th percentile for S i value of 21, and QUICKI (quantitative insulin sensitivity check index) and McAuley indexes of 0.33 and 5.8, respectively. The S i index correlated (P Ͻ 0.001) with all the indirect indexes and parameters of the metabolic syndrome.CONCLUSIONS -When compared with the S i index, the most sensitive and specific indirect method was the score proposed by McAuley et al. (specificity 0.91, sensitivity 0.75, 9.2 probability ratio of a positive test), followed by the existence of metabolic syndrome (specificity 0.91, sensitivity 0.66, 7.8 probability ratio of a positive test). Diabetes Care 26:3320 -3325, 2003I nsulin resistance (IR) is a pathological situation characterized by a lack of physiological response of peripheral tissues to insulin action, leading to the metabolic and hemodynamic disturbances known as the metabolic syndrome (1). The main features of this condition include dyslipidemia (high triglyceride and low HDL cholesterol levels), hypertension, glucose intolerance or type 2 diabetes, hyperuricemia or gout, abdominal obesity, hypercoagulability and defects in the fibrinolytic system, hyperandrogenism, fatty liver, and an increased incidence of coronary heart disease (1).The interest of IR and metabolic syndrome lies in their high prevalence in the population and the associated high death rate, fundamentally through coronary heart disease, even in nondiabetic subjects (2,3). The connection between IR, hyperinsulinemia, and coronary heart disease has been established by several transverse, prospective, and experimental studies (4 -8). Difficulties in measuring insulin sensitivity, however, prevent identification of insulin-resistant individuals in the general population.The quantification of IR can be performed by evaluating the peripheral insulin sensitivity in vivo with methods such as the pancreat...

The results of the 5th and final year, Fiscal Year 2003, are included in Table 1. We obviously did not come close to realizing this ambitious goal. In my 1998 Presidential Address, I compared the ADA to a large ship in which a new course first required a change of direction (which would occur slowly) before proceeding toward and hopefully reaching a new port. It's obvious that we have not reached that port, and realistically speaking, we probably never will. However, I would be remiss if I didn't point out the following. In each of the previous years, the increase in funding for Research Awards and Grants was much less than 50% of the increase in Total Public Support. In the last fiscal year, in which there was a severe economic downturn, Total Public Support increased much less than in previous years. However, the increase in research funding actually exceeded the increase in Total Public Support. To return to a perhaps tortured metaphor, although we probably will never reach the port promised 5 years ago, we seem to be headed in the right direction. That's certainly a positive sign and speaks well for the future of research funding by the ADA.