Insulin Resistance in Pediatric Populations
Summary
Insulin resistance in children and adolescents has emerged as a pivotal factor in the early pathogenesis of metabolic and cardiovascular disorders. Characterised by diminished cellular responsiveness to insulin, this condition often co-exists with obesity but may also arise in the context of genetic syndromes, hormonal therapies or sedentary lifestyles. The dysregulation of glucose homeostasis in young people predisposes to type 2 diabetes, non-alcoholic fatty liver disease and dyslipidaemia, setting the stage for long-term morbidity. The complexity of insulin resistance reflects a web of interrelated mechanisms, including ectopic lipid accumulation, low-grade inflammation, altered adipokine profiles and endothelial dysfunction. Early identification is challenging, as gold-standard techniques such as the hyperinsulinaemic euglycaemic clamp are resource-intensive and unsuitable for routine paediatric practice. Instead, a range of surrogate indices—most notably the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)—are employed to estimate insulin sensitivity. Interventions centre on lifestyle modification, with growing evidence that increased physical activity and dietary optimisation can reverse early abnormalities. In selected high-risk cases, adjunctive pharmacotherapy may be warranted to delay progression to overt diabetes. Ongoing research emphasises the need for age- and puberty-specific thresholds, culturally tailored approaches and integrative screening programmes to mitigate the rising tide of metabolic disease in young populations worldwide.
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Insulin Resistance in Pediatric Populations publication trend
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Technical terms
Insulin resistance: A physiological state in which peripheral tissues exhibit impaired responsiveness to circulating insulin, reducing glucose uptake and increasing insulin secretion.
HOMA-IR: Homeostatic Model Assessment for Insulin Resistance, a mathematical index derived from fasting insulin and glucose concentrations to approximate insulin sensitivity.
Hyperinsulinaemic euglycaemic clamp: The reference method for quantifying insulin sensitivity by infusing insulin at a constant rate while adjusting glucose infusion to maintain target blood glucose.
Metabolic syndrome: A cluster of interrelated metabolic abnormalities—abdominal obesity, dyslipidaemia, hypertension and hyperglycaemia—that collectively elevate cardiovascular and diabetic risk.
References
- Cord blood ceramides facilitate early risk identification into childhood metabolic health. National Science Review (2024).
- Longitudinal associations of lifestyle factors and weight status with insulin resistance (HOMA-IR) in preadolescent children: the large prospective cohort study IDEFICS. International Journal of Behavioral Nutrition and Physical Activity (2016).
- Insulin Resistance in Children. Frontiers in Endocrinology (2019).
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