Diabetes, obesity and hypertension: Role of insulin and the sympathetic nervous system

Type II diabetes mellitus is associated with peripheral insulin resistance and, in the great majority of cases, with obesity. The aggregation of i) obesity of the abdominal type, ii) hyperinsulinemia and insulin resistance, iii) hypertension, and iv) dyslipidemia, have been associated epidemiologically with increased cardiovascular risk. The relationship between the various manifestations of this <<insulin resistance syndrome>> remains uncertain. Data are presented herein demonstrating that involvement of the sympathetic nervous system, and perhaps the adrenal medulla, contribute to the pathogenesis of the various manifestations of the insulin resistance syndrome and, therefore, contribute to the increased cardiovascular risk that attends Type II diabetes.