Insulin resistance plays a key role in the development of type 2 diabetes mellitus and is also associated with several other diseases, such as obesity, hypertension, and cardiovascular diseases. Type 2 diabetes and obesity have become epidemic worldwide in the past few decades, and epidemiological and metabolic evidence indicates that the two conditions are linked closely through insulin resistance. The perturbation of free fatty acid (FFA) metabolism is now accepted to be a major factor contributing to whole-body insulin resistance, including that in skeletal muscle. Acute exposure to FFAs and excess dietary lipid intake are strongly associated with the pathogenesis of muscle insulin resistance. Despite an enormous amount of published research and the proposal of numerous hypotheses, however, the mechanisms underlying FFA-induced skeletal muscle insulin resistance have not been fully elucidated. This chapter describes existing hypotheses, recent findings, and debates about the role of FFAs in the development of muscle insulin resistance. Therapeutic options for this condition are also discussed.
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