Sir Harold Himsworth and insulin insensitivity 75 years on.

摘要

The biological defect known as insulin resistance is regarded as a major component in the pathogenesis of type 2 diabetes. At its most generic, insulin resistance (the inverse of insulin sensitivity) may be denned as an impaired biological effect of insulin at physiological concentrations. However, constraining this consideration to glucose does a disservice to insulin, a hormone with myriad metabolic, vascular, and genomic actions.In this issue of Diabetic Medicine, we commemorate the contributions to clinical science of Sir Harold Himsworth on the 75th birthday of his Lancet paper, a publication that has justly been described as seminal [1]. Decades before the development of a radioimmunoassay for insulin Himsworth showed that diabetes could be divided into what he termed 'insulin-sensitive' and 'insulin-insensitive' subtypes. In doing so, Himsworth effectively anticipated the modern classification of diabetes and its treatment.