The insulin resistance syndrome (IRS), also known as Syndrome X, includes insulin resistance, hyperinsulinemia, abdominal obesity, dyslipidemia with high triglyceride and low high-density lipoprotein cholesterol levels and hypertension. Each element of the insulin resistance syndrome has been firmly established as a risk factor for development of diabetes, and most of these elements are also well-recognized cardiovascular risk factors. Dr. Birdsall will discuss the diagnosis of IRS, review related metabolic factors and present integrated treatment options.