The goal of this study is to aggressively treat insulin resistance and its clinical
manifestations when they first appear in childhood, and to prevent the subsequent
progression towards impaired glucose tolerance and type-2 diabetes. In the process of this
clinical trial, we will learn more about the early manifestations of insulin resistance, its
treatment, and its relationship to obesity and type-2 diabetes through parallel in-vivo and
1. Obese patients (wt > 95th percentile for age, for adults increased BMI > 27) greater
than 5 years of age
2. And/or presence of complications of insulin resistance such as acanthosis nigricans,
dyslipidemia, elevated blood pressure, hyperandrogenism
3. Siblings and parents of patients with insulin resistance. Siblings and parents will
be included only in the case of documented insulin resistance in the index subject.
Insulin resistance will be documented by OGTT and/or IVGTT.
4. Family history of type II diabetes.
1. Critically ill patients, patients will congestive heart failure, renal or liver
2. Inability to give consent.
3. History of poor compliance with physician's recommendations