<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>In this review we discuss the biological significance
of D-chiro-inositol, originally discovered
as a component of a putative mediator of
intracellular insulin action, where as a putative
mediator, it accelerates the dephosphorylation
of glycogen synthase and pyruvate dehydrogenase,
rate limiting enzymes of non-oxidative
and oxidative glucose disposal.</p> <p>Early studies demonstrated a linear relationship
between its decreased urinary excretion
and the degree of insulin resistance present.
When tissue contents, including muscle, of type
2 diabetic subjects were assayed, they demonstrated
a more general body deficiency.
Administration of D-chiro-inositol to diabetic
rats, Rhesus monkeys and now to humans
accelerated glucose disposal and sensitized
insulin action.</p> <p>A defect <italic>in vivo</italic> in the epimerization of myoinositol to chiro-inositol in insulin sensitive tissues
of the GK type 2 diabetic rat has been elucidated.
Thus, administered D-chiro-inositol
may act to bypass a defective normal epimerization
of myo-inositol to D-chiro-inositol
associated with insulin resistance and act to at
least partially restore insulin sensitivity and glucose
disposal.</p>
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Int J Exp Diabetes Res. 2002; 3(1):47-60