Insulin resistance (IR) refers to subnormal response to a certain amount of insulin and is the most characteristic phenomenon in non-insulin dependent diabetes mellitus (NIDDM). It is also an element of the pathogenic mechanism shared with obesity, systemic hypertension, abnormal lipid metabolism and atherosclerosis. In recent years, studies on its treatment with traditional Chinese medicine (TCM) have gradually been carried out and the following is a report of them.Mechanisms of Diabetic IR in TCM TermsAction of insulin antagonizing hormones in peripheral tissues is one of the causes of diabetic IR. Cyclic nucleosides cAMP and cGMP, important intracellular messengers, are considered to be the second messenger of insulin, and cAMP is related to the amount of insulin receptors. Early in 1980s, some authors investigated the relationship among the symptoms of diabetes and such hormones and cAMP/cGMP ratio. Although they did not give due attention to IR, their studies provided evidences for differentiation of symptoms and signs in IR typing.

It has been hypothesized that the defects of insulin receptors may play an important role in the insulin resistance of coronary heart disease. As a test of this hypothesis, 20 male patients with myocardial infarction, 20 male patients with type 2 diabetes mellitus and 20 normal subjects as control were investigated.Plasma insulin were determined; at the meantinme, insulin receptors of erythrocyte were indentified by means of 125 I -labeled insulin binding to erythrocytes while the affinity constants (K1 ,K2) and the number of receptors with different affinity and capacity (Q1,Q2) were calculated according to Scatchard＇s graphic method. The results showed that the number of insulin receptors with low affinity (Q2) on erythrocytes,K1, K, were lower in patients with myocardial infarction than those in controls ; and Q2, K1 in patents with type 2 diabetes mellitus were also lower. So we concluded that the mechanism of insulin resistance in coronary heart disease might be associated with insulin receptor and affinity abnormalities ,differed from that in diabetic state with some degree of post-receptor defects, which suggests that there may be an interrelationship among insulin receptor defects, insulin resistance,hyperinsulinemia in developing coronary heart disease.