Diabetes significantly raises the risk of heart attack and stroke. Now it appears that the risk may begin to rise with insulin resistance, the first step on the road to diabetes. Taking steps to improve insulin sensitivity when resistance first develops might prevent cardiovascular events from occurring later. "Physicians use blood sugar levels to screen for metabolic syndrome and diabetes. It may be an oversight that we do not screen for pre-diabetes by measuring insulin levels. Insulin resistance might be underdiagnosed, and we are missing a potential population for cardiovascular prevention," says Cleveland Clinic cardiologist and Gus P. Karos Chair in Clinical Cardiovascular Medicine, Curtis Rimmerman, MD.