Insulin resistance is a complicated disease in which your body does not react to the hormone insulin as it should, which is produced by the pancreas and is crucial for controlling blood sugar levels. Insulin resistance may be caused by a variety of hereditary and environmental causes.
Insulin resistance: what is it?
Insulin resistance, sometimes referred to as decreased insulin sensitivity, occurs when cells in your muscles, fat, and liver don’t react to insulin as they should. Insulin is a hormone produced by your pancreas that is vital for life and controls blood glucose (sugar) levels. Insulin resistance may either be acute or chronic, and it sometimes can be treated.
The following stages describe how insulin works normally:
- Your body converts the food you consume into glucose (sugar), which is used as the body’s primary energy source.
- Your blood is exposed to glucose, which instructs your pancreas to produce insulin.
- Your muscle, fat, and liver cells may utilize the glucose in your blood for energy or store it for later use with the aid of insulin.
- Your bloodstream’s decreased glucose levels tell your pancreas to cease making insulin as soon as glucose reaches your cells.
Your muscle, fat, and liver cells may react improperly to insulin for a variety of reasons, making it difficult for them to adequately absorb or retain glucose from your blood. It’s called insulin resistance. Your pancreas produces more insulin as a consequence in an effort to combat your rising blood glucose levels. It’s known as hyperinsulinemia.
Your blood sugar levels will remain within a safe range as long as your pancreas can produce enough insulin to override your cells’ subpar response to insulin. Hyperglycemia, which results from your cells’ excessive insulin resistance, causes raised blood glucose levels (hyperglycemia), which eventually cause prediabetes and Type 2 diabetes.
Insulin resistance is linked to a number of additional illnesses outside Type 2 diabetes, such as:
- Obesity.
- the cardiovascular system.
- liver fatty liver without alcohol.
- Syndrome metabolic.
- PCOS, or polycystic ovarian syndrome.
What distinguishes diabetes from insulin resistance?
Anyone may have insulin resistance, whether it is short-term or persistent. If persistent insulin resistance is not addressed or is not manageable, it might eventually result in prediabetes and Type 2 diabetes.
When blood glucose levels are above normal but not high enough to be classified as diabetes, you have prediabetes. People with some level of insulin resistance are more likely to develop prediabetes.
Type 2 diabetes (T2D), the most prevalent form of diabetes, may result from prediabetes. T2D is characterized by high blood glucose levels brought on by insufficient insulin production by the pancreas or poor insulin utilisation by the body (insulin resistance).
When the insulin-producing cells in your pancreas are attacked and destroyed by your immune system for an unidentified cause, type 1 diabetes (T1D) results. T1D is an autoimmune, chronic condition that requires synthetic insulin injections to maintain life and health. Despite the fact that insulin resistance is not the cause of T1D, it may occur in T1D patients to the point where their cells do not react properly to the insulin that is administered.
A transient type of diabetes that may develop during pregnancy is gestational diabetes. It is brought on by insulin resistance, which is brought on by hormones produced by the placenta. After giving birth, gestational diabetes disappears. Gestational diabetes is a condition that affects between 3% and 8% of all pregnant individuals in the US.
Glycated hemoglobin (A1c) blood tests are often used by medical professionals to identify diabetes. It displays your three-month average blood sugar level. All in all:
- A1c levels under 5.7% are regarded as normal.
- The A1c range of 5.7% to 6.4% is regarded as prediabetes.
- Type 2 diabetes is identified by an A1c score of 6.5% or above on two different tests.
Because their pancreas is making little to no insulin, people with Type 1 diabetes often have a very high A1C and extremely high blood glucose levels when they are first diagnosed.
Who is affected by insulin resistance?
Anyone may develop it; you don’t need to have diabetes. Insulin resistance can be either transitory (taking steroid medicine for a short time might produce it) or chronic. Excess body fat, particularly in the abdomen, and a lack of exercise appear to be the two primary causes of insulin resistance.
The majority of people with prediabetes and Type 2 diabetes have some degree of insulin resistance. It may potentially be a complication of Type 1 diabetes.
The frequency of insulin resistance?
The simplest approach to gauge the prevalence is by counting the number of prediabetes cases since there are no routine tests to screen for it and no symptoms until it progresses to prediabetes or Type 2 diabetes. In the US, more than 84 million persons have prediabetes. This equates to around one in three adults.
How does my body respond to insulin resistance?
In order to maintain appropriate blood sugar levels, your body produces more insulin (hyperinsulinemia) as insulin resistance progresses. Increased insulin levels may cause weight gain, which exacerbates insulin resistance.
The following conditions are also linked to hyperinsulinemia:
- Higher amounts of triglycerides.
- Atherosclerosis is the hardening of the arteries.
- Hypertension is a term for high blood pressure.
A group of characteristics known as the metabolic syndrome, which links excess abdominal fat and insulin resistance to an increased risk of cardiovascular disease, stroke, and Type 2 diabetes, also has it as its core characteristic.
The following are characteristics of metabolic syndrome:
- elevated glucose levels in the blood.
- a high amount of triglycerides.
- Low HDL cholesterol (high-density lipoprotein) levels.
- elevated blood pressure.
Metabolic syndrome may exist without having all four of these characteristics.
SIGNIFICANCE AND CAUSES
What signs of insulin resistance are there?
You won’t experience any symptoms if you have insulin resistance but your pancreas may produce more insulin to maintain normal blood sugar levels.
The cells in your pancreas that produce insulin might, however, deteriorate and become more resistant to insulin over time. Your pancreas eventually loses the ability to generate enough insulin to overcome the resistance, which results in hyperglycemia, or high blood sugar, which does result in symptoms.
High blood sugar symptoms include:
- higher thirst.
- urinating (peeing) often.
- increased appetite.
- vision that is hazy.
- Headaches.
- Skin and vaginal infections.
- slow-healing wounds and sores.
Many individuals, often for years, are prediabetic yet show no symptoms. Prior to turning into Type 2 diabetes, prediabetes could go undetected. The following signs and symptoms are sometimes present in patients with prediabetes:
- Acanthosis nigricans, or darkened skin, is a condition that affects the armpits, back, and sides of the neck.
- Small skin growths known as skin tags.
- alterations in the eyes that might cause diabetic retinopathy.
It’s crucial to consult your doctor if you have any of these symptoms.
Why does insulin resistance occur?
Researchers still have a lot to learn about how insulin resistance manifests itself. They have so far discovered a number of genes that influence a person’s likelihood of developing reduced insulin responsiveness. Additionally, it is more common in elderly adults.
Insulin resistance may occur to varied degrees due to a number of situations and circumstances. Inactivity and extra body fat, particularly in the abdominal region, are thought to be the two primary causes.
Causes of insulin resistance that are acquired
The following are examples of acquired causes of insulin resistance, meaning they weren’t present at birth:
Extra body fat: According to researchers, obesity, particularly extra body fat in the abdomen and around the organs (visceral fat), is the main factor causing insulin resistance. Insulin resistance is associated with waist measurements of at least 35 inches for women and persons assigned female at birth, and at least 40 inches for males and those designated male at birth. According to studies, abdominal fat produces hormones and other chemicals that might fuel chronic inflammation in the body. This inflammatory response might contribute to insulin resistance.
Physical inactivity: Exercise increases insulin sensitivity and develops muscles that can absorb glucose from the circulation. Lack of exercise might have the opposite effect and lead to insulin resistance. Additionally, a sedentary lifestyle and a lack of exercise are linked to weight increase, which may also cause insulin resistance.
Saturated fats, high-carbohydrate diets, and highly process meals have all been associate to insulin resistance. High-process, high-carbohydrate meals are digest rapidly by your body, which raises your blood sugar levels. Your pancreas is under additional strain to generate a lot of insulin as a result, and this might eventually result in insulin resistance.
Some drugs: Some drugs, including steroids, some blood pressure medicines, some HIV therapies, and some psychiatric drugs, may lead to insulin resistance.
Diabetes-related hormonal issues that might result in resistance
Numerous hormones, which are substances that coordinate various bodily processes by sending instructions to your organs, muscles, and other tissues via your blood, are produce by your body on a daily basis. These messages instruct your body on what to do when.
How well your body utilizes insulin may be impact by problems with certain hormones. The following hormonal conditions may result in insulin resistance:
Cushing’s syndrome: This disorder develops when your body produces too much cortisol. The “stress hormone,” cortisol, is essential for controlling your blood sugar levels (by elevating them) and converting food into energy. Insulin resistance may result from an excess of cortisol, which inhibits the actions of insulin.
Acromegaly: High amounts of growth hormone (GH) may cause this uncommon but dangerous illness. Increased glucose production brought on by high GH levels might result in insulin resistance.
When your thyroid is underactive and not producing enough thyroid hormone, you have hypothyroidism. Your metabolism—the process by which your body turns food into energy—is greatly influenced by your thyroid. Your metabolism, including the way you process glucose, slows down when your thyroid gland produces too little thyroid hormone. This may result in insulin resistance.
Inherited traits that lead to insulin resistance
For a variety of causes, many inherited genetic disorders (disorders you are born with) might result in insulin resistance.
A spectrum of uncommon illnesses known as hereditary extreme insulin resistance syndromes are group together in this way. These syndromes are list from least severe to most severe and include:
Type A insulin resistance syndrome: It affects the body’s ability to regulate blood sugar, which eventually results in diabetes. The signs of reduced insulin responsiveness and associated conditions sometimes don’t show up until adolescence or later. In most cases, it is not life-threatening.
Rabson-Mendenhall syndrome: Affected newborns fail to thrive, which means they don’t develop and gain weight at the typical pace. Rabson-Mendenhall syndrome patients are particularly tiny from before birth. Rabson-Mendenhall syndrome patients show early warning signs and symptoms and survive into their teens or early 20s. Diabetes-related complications often end in death.
Donohue syndrome: Affected newborns fail to grow and people with Donohue syndrome are particularly tiny from before birth. A lack of adipose tissue under the skin, muscular atrophy, and excessive body hair development (hirsutism) are further signs that emerge shortly after delivery. Most affected youngsters don’t live beyond the age of two.
The following other hereditary diseases may result in insulin resistance:
Myotonic dystrophy is a kind of muscular dystrophy that affects the pancreas, muscles, eyes, and endocrine system organs. People with myotonic dystrophy have a 70% reduction in muscle insulin sensitivity, which results in insulin resistance.
Alström syndrome is a rare genetic disorder that causes dilated cardiomyopathy, obesity, Type 2 diabetes, low stature, and a gradual loss of vision and hearing.
Werner syndrome: This is an uncommon progressive condition that manifests as progeria, or extremely rapid aging. It has an impact on a variety of bodily functions, including insulin resistance and aberrant insulin production.
A disorder known as inherited lipodystrophy causes an improper usage and storage of fat by the body. The inability of extra glucose to be store in adipose tissue is the primary cause of insulin resistance in lipodystrophy.
TESTS AND DIAGNOSIS
How is insulin sensitivity identified?
Because there is no systematic testing for it, diagnosing insulin resistance may be challenging. You won’t experience any symptoms as long as your pancreas is making enough insulin to overcome the resistance.
Since there isn’t a single test that can accurately identify insulin resistance, your healthcare professional will take a number of things into account when determining whether you have the condition. These include:
- medical background.
- Family background.
- exam of the body.
- symptoms and signs.
- Test outcomes.
What examinations will be conduct to assess insulin resistance?
The following blood tests may be prescribe by your doctor to identify reduce insulin responsiveness, prediabetes, or diabetes:
Fasting plasma glucose (FPG) or a glucose tolerance test (GTT) may be use to detect, diagnose, and/or track the presence of gestational diabetes, type 2 diabetes, or prediabetes.
Glycated hemoglobin A1c (A1c) testing: This procedure displays your three-month average blood glucose levels.
A lipid panel is a collection of tests that determines the levels of certain lipids in your blood, including triglycerides, total cholesterol, LDL cholesterol, and HDL cholesterol.
In addition, your doctor could request testing to identify additional illnesses including metabolic syndrome, cardiovascular disease, or polycystic ovarian syndrome (PCOS) that are link to insulin resistance.
CONTROL AND TREATMENT
What is the remedy for insulin resistance?
The main therapy for insulin resistance is lifestyle changes since some of the causes of reduce insulin responsiveness, such genetics and age, cannot be change. Changes in lifestyle include:
Eating a nutritious diet: Your doctor or dietitian may advise against consuming large quantities of carbs since they cause the body to produce too much insulin. They may also advise against consuming too much unhealthy fat, sugar, red meat, and processed carbohydrates. Instead, they’ll probably advise consuming a diet rich in whole foods, which includes more fruits, vegetables, whole grains, fish, and lean meat.
Exercise: Engaging in regular, moderate-intensity exercise helps to boost glucose energy consumption and enhance muscle insulin sensitivity. Exercise of a moderate intensity may boost glucose uptake by at least 40% in a single session.
Losing weight: In order to attempt addressing insulin resistance, your doctor may advise you to try to reduce weight. According to one research, 7% weight loss may delay the development of Type 2 diabetes by 58%.
These changes in lifestyle over time can:
- Boost insulin sensitivity.
- Reduce your blood sugar levels.
- Bring down blood pressure.
- Lower the levels of LDL (“bad”) cholesterol and triglycerides.
- increase HDL (“good”) cholesterol levels.
Along with your primary care physician, you could collaborate with additional medical professionals to develop a personalized treatment plan that is most effective for you. Examples of these professionals include a dietitian and an endocrinologist.
What drugs are use for the treatment?
Although there are presently no drugs especially for treating insulin resistance, your doctor may recommend drugs to address comorbid illnesses. Several instances include:
- medicine to lower blood pressure.
- For diabetes, use metformin.
- To reduce LDL cholesterol, use statins.
Can insulin resistance be treat?
Numerous variables and causes contribute. Not all reasons of reduce insulin responsiveness and sensitivity can be reverse, despite the fact that lifestyle modifications including eating a nutritious diet, exercising often, and decreasing weight may raise insulin sensitivity and reduce it.
Talk to your doctor about the best ways to manage it.
What role does nutrition have in insulin resistance?
Your blood sugar and insulin levels are significantly influence by your food. Foods that are heavily process, heavy in carbohydrates, and high in fat need more insulin.
In general, eating fewer high-glycemic-index meals and more low- to medium-glycemic-index foods may help you reverse and/or manage insulin resistance. Because fiber takes more time for your body to digest than other meals, eating foods high in fiber helps to prevent blood sugar spikes.
According to how much they impact your blood sugar levels, meals that include carbs are rank on the glycemic index (GI). The Glycemic Index Foundation (GIF) rates the glycemic index (GI) of foods as low, medium, or high, using pure glucose as a standard at 100:
- Low GI: 55 or under.
- GI medium: 56-69.
- GI of 70 or higher
Foods with a high GI tend to be high in sugar and/or carbs and low to nil in fiber. Foods with a low glycemic index often have lower carbohydrate content and greater fiber content.
Foods having a high GI include, for instance:
- plain bread.
- Potatoes.
- cereals for breakfast.
- cookies and cake.
- fruits like dates and melons.
Foods having a low GI include, for instance:
- legumes and beans.
- fruits like berries and apples.
- veggies that aren’t grains, such asparagus, cauliflower, and leafy greens.
- Nuts.
- beef, fish, and dairy.
Before making significant dietary changes, always with your doctor.
PREVENTION
What are the possible causes?
Your chance of developing is increase by a number of hereditary and lifestyle risk factors. Risk elements consist of:
- obesity or being overweight, particularly having extra belly fat.
- 45 years of age or more.
- an immediate family member (parent, sibling, etc.) who has diabetes.
- a sedentary way of life.
- a few medical issues, include excessive cholesterol levels and high blood pressure.
- gestational diabetes in the past.
- an earlier heart attack or stroke.
- the presence of a sleeping problem like sleep apnea.
- Smoking.
Additionally, those who belong to one of the following racial or ethnic groups are more likely to have reduced insulin responsiveness or prediabetes:
- American Asian.
- Black.
- Hispanic/Latino.
- Native Americans from Alaska.
- Native Americans who live on the continent of the United States.
- persons who are native to the Pacific Islands.
Although there are certain risk factors for reduced insulin responsiveness that you cannot control, such as age or family history, you may attempt to reduce your risk by keeping a healthy weight, eating a balanced diet, and engaging in regular exercise.
PERSPECTIVE / PROGNOSIS
What is the insulin resistance prognosis (outlook)?
The prognosis (outlook) is influence by a number of variables, including:
- why doest it exist?
- how bad it is.
- how effectively your cells that make insulin are functioning.
- how likely it is that consequences will occur.
- therapy compliance and your body’s reaction to the therapy.
It’s possible for someone to have minor insulin resistance without developing prediabetes or Type 2 diabetes. A person may also develop reduced insulin responsiveness, which is relatively treatable or reversible with a change in lifestyle. It may be fatal or life-threatening for certain persons with hereditary diseases that result in extreme insulin resistance.
Ask your doctor about what to anticipate if you develop reduced insulin responsiveness and the best ways to treat it.
What consequences does insulin resistance have?
The bulk of the issues that might arise from reduce insulin responsiveness are link to the vascular (blood vessel) difficulties that can arise from hyperinsulinemia and increase blood sugar levels.
Not all individuals with reduced insulin responsiveness will have difficulties. It’s crucial to see your doctor often and adhere to your treatment plan if you have Type 2 diabetes, metabolic syndrome, or insulin resistance in order to attempt to avoid these consequences.
LIFE WITH
When should I schedule a consultation with my doctor concerning insulin resistance?
It’s crucial to see your doctor often if you have been diagnose with insulin resistance or diseases associate to it in order to ensure that your blood sugar levels are within a healthy range and that your therapy is having the desired effect.
Contact your healthcare practitioner if you are exhibiting signs of prediabetes or high blood sugar. To assess your blood sugar levels, they may do quick tests.
Consult your healthcare professional about your risk of developing reduced insulin responsiveness if you have a family history of diabetes or other diseases that may lead to it.
What inquiries ought I to make of my physician?
Asking your doctor the following questions might be beneficial if you have been told you have insulin resistance:
- Why is my insulin resistance occurring?
- What can I do to improve my sensitivity to insulin?
- What is the likelihood that I will have Type 2 diabetes or prediabetes?
- Is there anything I can take for medicine?
- Should I get a diagnosis?