What Is Insulin Resistance?
People with insulin resistance, also known as impaired insulin sensitivity, have built up a tolerance to insulin, making the hormone less effective. As a result, more insulin is needed to persuade fat and muscle cells to take up glucose and the liver to continue to store it.
It is still a mystery that why a person fails to respond properly to insulin. But there are ways to make the body more receptive to insulin, which can help prevent or delay type 2 diabetes—or help someone with type 1 diabetes manage their blood glucose (blood sugar).
In response to the body's insulin resistance, the pancreas deploys more of the hormone to keep cells energized and manage blood glucose levels in a healthy range. This is why people with type 2 diabetes tend to have higher levels of circulating insulin. The ability of the pancreas to increase insulin production means that insulin resistance alone won't have any symptoms at first. Over time, though, insulin resistance tends to get worse, and the pancreatic beta cells that make insulin can wear out. Eventually, the pancreas no longer produces enough insulin to overcome the cells' resistance. The result is higher blood glucose levels, and ultimately prediabetes or type 2 diabetes.
Insulin has other roles in the body besides regulating blood glucose levels, and the effects of insulin resistance are thought to go beyond diabetes. For example, some research has shown that insulin resistance, independent of diabetes, is associated with heart disease.
Insulin resistance syndrome includes a group of problems like obesity, high blood pressure, high cholesterol, and type 2 diabetes, it can be called as metabolic syndrome.
What Causes Insulin Resistance?
Several genes have been identified that make a person more or less likely to develop the condition. It's also known that older people are more prone to insulin resistance. Lifestyle can play a role, too. Being sedentary, overweight or obese increases the risk for insulin resistance. Why? It's not clear, but some researchers theorize that extra fat tissue may cause inflammation, physiological stress or other changes in the cells that contribute to insulin resistance. There may even be some undiscovered factor produced by fat tissue, perhaps a hormone, that signals the body to become insulin resistant.
Many factors contribute to insulin resistance.
One possible cause is increased levels of free fatty acids in your blood, which can cause cells to stop responding properly to insulin.
The main causes of elevated free fatty acids are consumption of too many calories and the presence of excess body fat. In fact, overeating, weight gain, and obesity are all strongly associated with insulin resistance.
Visceral fat, the harmful belly fat that can accumulate around your organs, may release many free fatty acids into your blood, as well as inflammatory hormones that drive insulin resistance.
Although insulin resistance is more common among people with overweight or obesity, anyone can develop it.
Other potential causes of insulin resistance include:
Excessive fructose consumption: High intake of fructose — from added sugars, not from fruit — has been linked to insulin resistance.
Chronic inflammation: Increased oxidative stress and inflammation in your body may lead to this condition.
Inactivity: Physical activity increases insulin sensitivity, while inactivity may contribute to insulin resistance.
Problems with gut microbiota: Evidence suggests that a disruption in the bacterial environment in your gut can cause inflammation, which may worsen insulin resistance and other metabolic problems.
Symptoms of Insulin Resistance
You can't tell that you have insulin resistance by how you feel. You'll need to get a blood test that checks your blood sugar levels. Likewise, you won’t know if you have most of the other conditions that are part of insulin resistance syndrome (high blood pressure, low "good" cholesterol levels, and high triglycerides) without seeing your doctor.
Some signs of insulin resistance include:
A waistline over 40 inches in men and 35 inches in women
Blood pressure readings of 130/80 or higher
A fasting glucose level over 100 mg/dL
A fasting triglyceride level over 150 mg/dL
An HDL cholesterol level under 40 mg/dL in men and 50 mg/dL in women
Skin tags
Patches of dark, velvety skin called acanthosis nigricans
Risk Factors and Causes of Insulin Resistance
Things that can make this condition more likely include:
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
How is it treated?
Reversing insulin resistance and preventing type two diabetes is possible through lifestyle changes, medication, or sometimes both. Healthy bodies come in different shapes and sizes. Losing weight through drastic means can be dangerous and counterproductive. Instead, get ideas from a doctor or a nutritionist about ways to incorporate healthy foods like fruits, vegetables, nuts, beans, and lean proteins into your meals. Also, consider incorporating exercise and movement into your day-to-day life in ways that make you feel good.
What Does It Mean for Your Health?
Insulin resistance comes in degrees. The more insulin resistant a person with type 2 is, the harder it will be to manage their diabetes because more medication is needed to get enough insulin in the body to achieve target blood glucose levels.
Insulin resistance isn't a cause of type 1 diabetes, but people with type 1 who are insulin resistant will need higher insulin doses to keep their blood glucose under control than those who are more sensitive to insulin. As with type 2, people with type 1 may be genetically predisposed to become insulin resistant, or they may develop resistance due to being overweight. Some research indicates that insulin resistance is a factor in cardiovascular disease and other complications in people with type 1.
Lifestyle Modifications
While it may not be possible to defeat insulin resistance entirely, there are ways to make the body’s cells more receptive to insulin.
Getting active is probably the best way to combat insulin resistance. Exercise can dramatically reduce insulin resistance in both the short and long terms. In addition to making the body more sensitive to insulin and building muscle that can absorb blood glucose, physical activity opens up an alternate gateway for glucose to enter muscle cells without insulin acting as an intermediary, reducing the cells' dependence on insulin for energy. While this doesn't reduce insulin resistance itself, it can help people who are insulin resistant improve their blood glucose control.
Weight loss can also cut down on insulin resistance. No single diet has been proved to be the most effective. Some evidence suggests, though, that eating foods that are low in fat and high in carbohydrates can worsen insulin resistance. Research has also shown that people who undergo weight-loss surgery are likely to become significantly more sensitive to insulin.
· No medications are specifically approved to treat insulin resistance. Yet diabetes medications like metformin and thiazolidinediones, or TZDs, are insulin sensitizers that lower blood glucose, at least in part, by reducing insulin resistance.
Don’t Give Up
While fighting an invisible foe can feel frustrating and discouraging, know that you are not alone. There are effective tactics to combat insulin resistance. Losing weight, exercising more or taking an insulin-sensitizing medication can help you get back to good blood glucose control and better health.
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