Inflammation in the insulin-resistant endotype of diabetes: consequences for prevention and treatment

The link between inflammation and insulin resistance is well-documented, particularly in the context of obesity, where chronic subclinical inflammation contributes to the development of type 2 diabetes. Recent efforts to subclassify diabetes into distinct endotypes based on key pathophysiological variables have revealed elevated levels of proinflammatory biomarkers in certain endotypes, such as the endotype with severe insulin-resistant diabetes (SIRD). Chronic inflammation not only amplifies the burden of diabetes but also undermines the efficacy of glucose-lowering medication, calling for targeted interventions to complement existing treatment. Addressing subclinical inflammation through lifestyle interventions and pharmacotherapeutic agents represents a promising avenue for both prevention and treatment, offering potential benefits in mitigating diabetes complications within personalized medicine.