Expert Forum Reframes Insulin Resistance as Diverse, Context-Dependent Responses

A review from the 2025 Diabetes, Diabetes Care, and Diabetologia Expert Forum examines why insulin resistance remains difficult to characterize and treat despite its central role in type 2 diabetes and other metabolic diseases. Journal editors convened the forum in September 2025 ahead of the 61st European Association for the Study of Diabetes Annual Meeting. The article synthesizes expert perspectives and research priorities rather than reporting a new clinical study.

The authors describe insulin resistance as a diverse, highly plastic set of adaptive, maladaptive, acute, and chronic responses—not a single, uniform pathophysiological condition. These responses vary across tissues, biological processes, individuals, and physiological and environmental conditions. The review covers whole-body and tissue-specific measurement methods, the two main insulin signaling networks, and current therapeutic options, whose effects on insulin resistance are described as mostly indirect.

For clinicians and researchers, the review emphasizes the complexity underlying insulin resistance and the need to investigate variability and pathway-specific defects to guide targeted therapies. The supplied abstract reports no quantitative treatment effects or new clinical outcome data. Full text was unavailable, limiting assessment of the evidence supporting specific therapeutic strategies; the item should not be interpreted as a new treatment guideline.