The study objective was to determine whether CMD alone, or in combination with metformin (M) or metformin plus low-dose rosiglitazone (MR), could reduce insulin levels and improve established risk factors for diabetes and metabolic syndrome in women with Syndrome W. The study was designed to evaluate two hypotheses: (1) A significant proportion of women with progressive midlife weight gain have undetected and potentially correctable insulin elevations which impede weight loss. The gene discussed is INS; the disease is metabolic syndrome.