Diabetes mellitus has now assumed epidemic proportions in many countriesof the world. With the present population of 19.4 million diabetics, and approximately 60 million bythe year 2025, India would rank first in its share of the global burden of diabetes. Diabetes mellitusis characterized by derangement in carbohydrate, protein, and fat metabolism caused by complete or relativeinsufficiency of insulin secretion and/or insulin action. There are two main forms of diabetes, type1 (insulin-dependent diabetes mellitus) and type 2 (non-insulin-dependent diabetes mellitus). Insulinsensitizers (thiazolidinediones), new-generation insulin secretagogue (glimepiride), acarbose, and designerinsulin (lispro and aspart) have enormously helped in achieving better metabolic control. Despite thegreat strides that have been made in the understanding and management of type 2 diabetes, insulin resistanceand diabetes-related complications are increasing unabated. The present review not only updates our knowledgein delineating the molecular mechanism(s) causal to insulin sensitivity or resistance, but also providesclues for the prognosis of diabetes and its better management.

Keywords: Diabetes Complications - physiopathology, Alcohol Drinking, Insulin Resistance, Metabolic Syndrome X - therapy