Connect
MJA
MJA

A picture is worth a thousand words

Chris Strakosch
Med J Aust 2007; 186 (5): 271. || doi: 10.5694/j.1326-5377.2007.tb00894.x
Published online: 5 March 2007

To the Editor: The authors of the article on insulin resistance1 challenge users of serum insulin levels to demonstrate benefit in clinical practice.

The problem for those of us who see patients with the metabolic syndrome (and occasionally find time to take a history and perform an examination) is that we are spectacularly unsuccessful in getting patients to lose weight. Everyone is able to lose some weight in the first flush of enthusiasm or when taking part in a trial with lots of encouraging assistants monitoring them, but they almost invariably run out of steam, and the weight goes back on — with interest.

I use the “worse still” measurement of insulin responses during an oral glucose tolerance test not to diagnose the metabolic syndrome, but as a method of motivating patients about the seriousness of the condition. A graph that shows the insulin response “off the page” makes a very effective propaganda tool (Box). An elevated fasting insulin level or, even better, very high insulin levels during an otherwise normal glucose tolerance test, is also very effective in indicating to parents of well children with obesity that diabetes is threatened. Otherwise, we are left with vague references to increased risk, which means little to the parents. One picture is worth a thousand words.

  • Chris Strakosch1

  • Department of Medicine, University of Queensland, Brisbane, QLD.


Correspondence: c.strakosch@uq.edu.au

  • 1. Samaras K, McElduff A, Twigg SM, et al. Insulin levels in insulin resistance: phantom of the metabolic opera? Med J Aust 2006; 185: 159-161. <MJA full text>

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.