The article provides a review of the literature on the possibilities of using various indices of insulin resistance in type 2 diabetes (T2DM) treatment. The main mechanisms of insulin resistance and its role in the formation of type 2 diabetes mellitus and other metabolic disorders are described. The main indices of insulin resistance, used in real clinical practice nowadays, are considered. Methods of their calculation are given. The effect of metformin and incretin active medications on insulin resistance is described. It was shown that the combination of these medications improves tissue sensitivity to insulin in patients with T2DM. Standard indicators for assessing glycemic control, such as fasting glucose and glycosylated hemoglobin (HbA1c), do not reflect the patient’s lipid metabolism. The use of insulin resistance assessment indices in patients with type 2 diabetes mellitus allows both, exercising glycemic control, and the metabolic disorders, often associated with carbohydrate metabolism disorders, monitoring. Using insulin resistance indices, it is possible to select the optimal treatment regimen for type 2 diabetes mellitus for a particular patient, to predict and evaluate the effectiveness of treatment in dynamics. Simple, generally available laboratory indicators and anthropometric data are used to calculate the indices of insulin resistance, and they are easy to measure. In this regard, the use of insulin resistance indices is possible in routine clinical practice.