Table 5. Metabolic effects of insulin and consequences of insulin resistance.

	Normal insulin action	Insulin-resistance state
Carbohydrates	↓Hepatic glucose production	Hyperglycemia
	↑Glucose utilization	Hyperinsulinemia
	↑Glycogenesis
Lipids	↓Lipolysis	↑Lipolysis
	↓Free fatty acids and glycerol	↑Free fatty acids and glycerol
	↑Lipogenesis	↑Hepatic triglyceride and apoB synthesis
	↑HDL	↓HDL
	↓Triglycerides	Hypertriglyceridemia
		↑Small dense LDL
Proteins	↓Gluconeogenesis	↑Gluconeogenesis
	↓Amino acids	↑Protein catabolism
	↑Protein synthesis	↓Protein synthesis
Purines	↑Uric acid clearance	Hyperuricemia
	↓Uric acid formation