Endothelial dysfunction is clearly mechanism that good explain the presence of microalbuminuria. This is also play a role in the etiology of coronary heart disease. Insulin has major effects on the endothelium producing vasodilatation mediator through the action of nitric oxide. Insulin resistance subjects, such those with obesity or with Type 2 Diabetes demonstrated resistance to the vasodilating action of insulin and this failure of insulin to produce an increased in muscle blood flow, may be responsible through failure of delivery of insulin and glucose for up to 40% of the resistance to the action of insulin seen in this insulin resistance subjects.