Intracellular starvation in the insulin resistance syndrome and type II diabetes mellitus.

Statistical associations of insulin resistance, type II diabetes, hypertension and hyperlipidemia have been well documented, but the pathophysiology of the 'insulin resistance syndrome' is unknown. This article explores the hypothesis that intracellular starvation plays a central role in the development of type II diabetes, hypertension and hyperlipidemia. According to this hypothesis, insulin resistance leads to inadequate intracellular glucose, which in turn leads to insufficient amounts of adenosine triphosphate needed for ion transfer, and to drive energy-requiring reactions. Indirect evidence supporting this hypothesis is presented. Intracellular starvation is also discussed as an alternative to the 'glucose hypothesis' to explain certain complications of diabetes.