Insulin Resistance
Insulin resistance is a pathological condition when cells within the body muscles, fat, and liver don’t respond normally to the hormone insulin and can’t without problems absorb glucose from the blood.
Insulin is a hormone made by the pancreas that allows glucose in the body to be absorbed by the cells in the muscles, fat, and liver for energy. As long as the pancreas can make sufficient insulin to overcome the cells’ weak response to insulin, the blood glucose levels will stay at a normal range.
When the cells cannot absorb the glucose, ranges of this sugar build up inside the blood. If glucose, or blood sugar, levels are higher than usual but now not high enough to indicate diabetes, doctors confer with this as prediabetes.
Insulin Resistance Development
Insulin is essential for regulating the quantity of glucose that circulates inside the bloodstream. It induces the cells to absorb glucose.
Insulin is also the chemical messenger that instructs the liver to keep a few glucose, in place of freeing it into the bloodstream. The liver packages glucose for storage in the form of glycogen.
As insulin resistance develops, the body fights back by way of producing more insulin. Over a duration of time, the beta cells on the pancreas might be running so hard to make insulin get worn out and may no longer keep up with the tempo for the demand for more insulin.
The blood sugar might as well start to rise and one may easily develop prediabetes or type 2 diabetes. In addition, he/she may also broaden non-alcoholic fatty liver disease (NAFLD), a growing condition related to insulin resistance that enhances your risk for liver damage and coronary heart disease.
Insulin Resistance Symptoms
You can’t tell that you have insulin resistance according to how your body feels. This is because insulin resistance does not usually present symptoms until diabetes develops. For confirmation of insulin resistance, there has to be a blood test that checks your blood sugar levels.
The following are certain symptoms of insulin resistance:
- A large waist.
A waist that measures 35 inches or more for women, 40 or more for men increases the odds of insulin resistance and metabolic syndrome, which is also linked to insulin resistance.
- High triglycerides. Levels of 150 or higher, or taking medication to treat high levels of these blood fats.
- Low HDLs. Low-density lipoprotein levels below 50 for women and 40 for men – or taking medication to raise low high-density lipoprotein (HDL) levels.
- High blood pressure. Readings of 130/85 mmHg or higher, or taking medication to control high blood pressure
- High blood sugar. Levels of 100-125 mg/dl (the prediabetes range) or over 125 (diabetes).
- High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.
Insulin Resistance Risk Factors
The following are things that make this condition more likely:
- Obesity, especially belly fat.
- Inactive lifestyle.
- Diet high in carbohydrates.
- Gestational diabetes.
- Health conditions like nonalcoholic fatty liver disease and polycystic ovary syndrome.
- A family history of diabetes.
- Smoking.
- Ethnicity — it’s more likely if your ancestry is African, Latino, or Native American.
- Age — it’s more likely after 45.
- Hormonal disorders like Cushing’s syndrome and acromegaly.
- Medications like steroids, antipsychotics, and HIV medications.
- Sleep problems like sleep apnea.
Insulin Resistance Causes
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Lifestyle Factors
Dietary factors probably make a contribution to insulin resistance, however, causative foods are hard to determine given the constraints of nutrition research.
Foods that have independently been connected to insulin resistance encompass those high in sugar with excessive glycemic indices, excessive in dietary fat and fructose, low in omega-3 and fiber, and which are hyper-palatable which will increase the threat of overeating.
Overconsumption of fat- and sugar-rich food and beverages have proposed as a fundamental thing behind the metabolic syndrome epidemic.
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Medications
Some medications are associated with insulin resistance including corticosteroids, protease inhibitors (a type of HIV medication), and atypical antipsychotics.
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Hormones
Many hormones can induce insulin resistance including cortisol, growth hormone, and human placental lactogen. Cortisol counteracts insulin and can lead to increased hepatic gluconeogenesis, reduced peripheral utilization of glucose, and increased insulin resistance. It does this by decreasing the translocation of glucose transporters (especially GLUT4) to the cell membrane.
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Diseases
Polycystic ovary syndrome and non-alcoholic fatty liver disease (NAFLD) are associated with insulin resistance. Hepatitis C also makes people three to four times more likely to develop type 2 diabetes and insulin resistance.
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Genetics
Several genetic loci have been determined to be associated with insulin insensitivity. This includes variation in loci near the NAT2, GCKR, and IGFI genes associated with insulin resistance. Further research has shown that loci near the genes are linked to insulin resistance. However, these loci are estimated to only account for 25-44% of the genetic component of insulin resistance.
Insulin Resistance Tests and diagnosis
A number of tests can help diagnose prediabetes and diabetes. Doctors usually request more than one of the tests below to ensure an accurate diagnosis. A doctor will use the following to diagnose insulin resistance:
- Questions. The doctor will want to know about your family’s medical history.
- Physical exam. The doctor will weigh you and check your blood pressure.
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Blood tests. You might get:
Fasting blood glucose test: A doctor checks glucose levels after a person refrains from eating or drinking for 8 or more hours.
Random glucose test: This involves a medical professional checking blood glucose levels at some point during the day.
Hemoglobin A1c test: This measures a person’s average blood sugar level over the previous 2–3 month
If blood sugar levels consistently fall outside of a normal range, it might indicate that the body is becoming resistant to insulin.
Insulin Resistance Complications
If this metabolic condition doesn’t go untreated, the following complications are likely to happen:
- Severe high blood sugar
- Heart attack
- Severe low blood sugar
- Eye problems
- Kidney disease
- Stroke
- Cancer
- Alzheimer’s disease
Insulin Resistance and Prediabetes
Insulin Resistance to Diabetes Connection
In a person with prediabetes, the pancreas works increasingly hard to release enough insulin to overcome the body’s resistance and keep blood sugar levels down. Over time, the pancreas’ ability to release insulin begins to decrease, which leads to the development of type 2 diabetes.
Insulin Resistance to Type 2 Diabetes
When you have insulin resistance, your pancreas makes extra insulin to make up for it. For a while, this will work and your blood sugar levels will stay normal. Over time, though, your pancreas won’t be able to keep up. If changes are not made in the way you eat and exercise, your blood sugar levels will rise until you have prediabetes. Your doctor will look for the following blood test results:
- Oral glucose tolerance test: 140-199 after the second test
- A1c results of 5.7% to 6.4%
- Fasting plasma glucose test: 100-125
If you aren’t able to manage prediabetes, you’ll be diagnosed with type 2 diabetes when your test levels reach:
- Fasting plasma glucose test: 126 or higher.
- Oral glucose tolerance test: 200 or higher after the second test.
- A1c results of 6.5% or above.
Insulin Resistance Treatment and Prevention
- Exercise: Muscles become more sensitive to insulin after exercise, and a person can reverse insulin resistance with an active, healthful lifestyle.
- Keep a healthy weight
- Eat a healthy diet
- Take medication
Insulin Resistance FAQs
Is insulin resistance a predictor of diabetes?
Insulin resistance is the best predictor of the metabolic syndrome in subjects with a first-degree relative with type 2 diabetes. With insulin resistance, obesity was associated with higher insulin resistance and diastolic blood pressure (BP), but no difference in other metabolic variables.
Insulin sensitivity rather than obesity is the major predictor of diabetes and is better at identifying obese individuals with a healthier metabolic profile.
What are the causes of insulin resistance in type 2 DM?
Individuals with type 2 diabetes suffer from insulin resistance and this means that their cells/organs are insensitive to insulin. In type 2 diabetes the body tries to compensate by producing more insulin, and also by increasing the number of insulin-producing cells
The driving forces behind insulin resistance in type 2 diabetes include excess body weight, too much belly fat, a lack of exercise, smoking, and even skimping on sleep. As insulin resistance develops, your body fights back by producing more insulin.
Does insulin resistance cause diabetes?
Insulin resistance may lead to diabetes in a manner that when the pancreas works increasingly hard to release enough insulin to overcome the body’s resistance and keep blood sugar levels down. Over time, the pancreas’ ability to release insulin begins to decrease, which leads to the development of type 2 diabetes.
How to know you are insulin-resistant?
You can’t tell that you have insulin resistance according to how your body feels. This is because insulin resistance does not usually present symptoms until diabetes develops. For confirmation of insulin resistance, there has to be a blood test that checks your blood sugar levels.
The following are certain symptoms of insulin resistance:
- A large waist.
A waist that measures 35 inches or more for women, 40 or more for men increases the odds of insulin resistance and metabolic syndrome, which is also linked to insulin resistance.
- High triglycerides. Levels of 150 or higher, or taking medication to treat high levels of these blood fats.
- Low HDLs. Low-density lipoprotein levels below 50 for women and 40 for men – or taking medication to raise low high-density lipoprotein (HDL) levels.
- High blood pressure. Readings of 130/85 mmHg or higher, or taking medication to control high blood pressure
- High blood sugar. Levels of 100-125 mg/dl (the prediabetes range) or over 125 (diabetes).
- High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.
How do lean people develop insulin resistance and diabetes?
Lean people develop insulin resistance from having too much insulin. They also have a gene type where their fat cells do not store a lot of fat and cannot create new fat cells.
When your body has too much insulin and nowhere to store the glucose, the other tissues become resistant to the insulin signal. So, glucose begins to back up in the blood.
Why does diabetic insulin resistance increase over time?
Under this condition, your pancreas produces even more insulin to lower your blood sugar levels. This leads to high insulin levels in your blood, termed hyperinsulinemia. Over time, your cells may become increasingly resistant to insulin, resulting in a rise in both insulin and blood sugar levels
Why is having a high insulin sensitivity good?
High insulin sensitivity allows the cells of the body to use blood glucose more effectively, reducing blood sugar.
How long does it take to reverse insulin resistance?
A minimum initial prolonged fast of 36 hours to 3 days may be needed to start the process of reversing insulin resistance. For morbidly obese patients Fung uses initial fasts of 7 to 21 days.
What is the biochemistry of insulin resistance?
Insulin resistance (IR) is a pathological condition in which cells fail to respond normally to the hormone insulin
What are some factors leading to insulin resistance?
Genetics, aging and ethnicity play roles in developing insulin sensitivity, however, in addition to the driving forces behind insulin resistance include excess body weight, too much belly fat, a lack of exercise, smoking, and even skimping on sleep. As insulin resistance develops, your body fights back by producing more insulin.
What are the earliest ways to detect insulin resistance?
- Fasting Glucose Test
In this test, you are asked to fast for eight hours before a blood sample is taken. If the glucose levels are above 100 after this time, there is a chance that you are suffering from insulin resistance.
- Oral glucose tolerance test. First, you’ll take the fasting glucose test.
- Hemoglobin A1c test. This blood test shows your average blood sugar level for the past 2 to 3 months.
Can insulin resistance cause hypoglycemia?
Too much insulin or other diabetes medications may cause your blood sugar level to drop too low, causing hypoglycemia. Hypoglycemia may also happen if you don’t eat as much food as usual after taking diabetes medication, or if you exercise more than you normally would.
What does ‘increased insulin sensitivity’ mean?
Insulin sensitivity refers to how sensitive the body’s cells are in response to insulin. High insulin sensitivity allows the cells of the body to use blood glucose more effectively, reducing blood sugar.
Do people with type 2 diabetes use insulin?
People with type 2 diabetes do not always have to take insulin right away; that is more common in people with type 1 diabetes. The longer someone has type 2 diabetes, the more likely it will require insulin. Just as in type 1 diabetes, insulin is a way to control your blood glucose level.