Polypeptide antagonists of the
human insulin receptor are provided. In some embodiments, a
pharmaceutical formulation is provided, comprising an INSR
antagonist as identified herein, and a pharmaceutically acceptable
excipient. The formulation may be provided in a unit
dose, e.g. a therapeutically effective
dose. In methods of the disclosure, an effective
dose of a an INSR
antagonist as identified herein is administered to an individual having, or at risk of having,
hyperinsulinemia, in a dose effective to stabilize, reduce or prevent clinical symptoms of the
disease. The individual may be monitored for clinical indicia of
disease before, during, and / or after administration.