Insulin resistance is a ubiquitous term used when talking about diabetes. Many people worldwide suffer from this condition, but it is usually undiagnosed until it becomes a major problem or converts into type 2 diabetes. Insulin resistance can be defined as the inability of your body to respond to the hormone insulin (1).
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What is Insulin?
Insulin is a peptide hormone that is secreted by the beta cells in the pancreas. It is an anabolic hormone that causes metabolic effects in your body. The insulin synthesised in the islets of Langerhans controls the energy utilisation and conservation in the body during the feeding and fasting states (2).
Insulin has a lot of functions, but one of its major functions is to utilise the carbohydrates present in your food. When broken down into simpler forms called glucose, the carbohydrates enter the bloodstream, where insulin allows the transfer of this glucose to various cells, including adipose tissues, muscle tissues, and liver, to be used as energy. If there is no insulin, the cells will not utilise the glucose in the blood and will not function effectively.
What is Insulin Resistance?
Insulin resistance is a condition where the body does not respond to insulin stimulation, including the adipose tissues, the muscle, and the liver cells (3). In simple words, these cells can not utilise carbohydrates to form energy from the blood. The pancreas starts making more insulin to balance this. As long as the pancreas keeps on making more insulin to mitigate this weak response of the cells, the blood sugar levels may remain stable. However, gradually it leads to a hike in blood sugar levels.
It is a condition called pre-diabetes. It means that your blood sugar levels are higher than the normal range but not high enough to be classified as diabetes. Pre-diabetes can happen when the body has insulin resistance or the pancreas is not making enough insulin (4).
Causes of Insulin Resistance
It has yet to be fully established what causes insulin resistance, but some factors are related to insulin resistance, and they are:
- Obesity- Obesity or even high abdominal fat can be the reason for insulin resistance. People who are over the normal range of BMI and have a diet that is high in carbohydrates suffer from insulin resistance (5).
- Lack of Exercise- Lack of exercise is also another cause of insulin resistance. People who do not follow an active lifestyle are also more prone to developing insulin resistance.
Some risk factors increase the chance of developing insulin resistance in people (6). These include;
- Family history
- Hormones
- Certain medication and steroid usage
- Smoking
- Hormonal imbalance
- Certain conditions
- High carbohydrate diet such as PCOS
- High cholesterol levels
- Sleep issues such as insomnia
- High blood pressure and other heart diseases
Symptoms of Insulin Resistance
There are usually no symptoms of insulin resistance. Most of the people who get diagnosed with insulin resistance or pre-diabetes, are found randomly during blood tests. Also, people suffering from certain conditions such as PCOS or any vascular disease are more prone to develop insulin resistance and are advised to take a blood glucose test.
In addition to this, a condition called Acanthosis nigricans or darkening and thickening of the skin in the groin, armpits and the back of the neck can also be the symptom of insulin resistance, but it is not the case with every patient. The symptoms of insulin resistance only start showing when it develops into type 2 diabetes.
How is Insulin Resistance Diagnosed?
The diagnosis of insulin resistance can be made through blood tests, and the doctors might use a combination of two of the given tests to confirm insulin resistance in patients. The tests are:
- A1C test- This test is done to check the HbA1C levels in the blood and measures three-month average blood sugar in the patient. It is one of the most accurate tests to know if a person is insulin resistant.
- Random glucose test- This is a daily glucose level check when the patient has had their regular meals.
- Fasting Glucose Test- This is a blood glucose test in a patient after 8 or more hours of fasting.
If the glucose levels are outside the normal range in two of these tests, then the person has insulin resistance. Insulin resistance and pre-diabetes usually go hand in hand, and the blood sugar levels can give results for pre-diabetic conditions only. In addition to this, the doctors will also consider the weight of the patient, their history of any disease such as PCOS, heart diseases, fatty liver etc. (7).
Treatment for Insulin Resistance
The treatment for insulin resistance is done through medicines in cases where the insulin resistance has led to type 2 diabetes. The medicines are either given in oral form or in the form of insulin injections. The insulin injections are only required for people with uncontrolled type 2 diabetes.
In addition to this, certain preventive measures such as regular exercise, a healthy diet, yoga, meditation, and losing weight can also benefit people with insulin resistance. Physical exercise can make your muscles more sensitive to insulin and might help reverse the condition (8).
Rather than treatment, there is a need for taking preventive measures. Although it is not possible to prevent insulin resistance in the case of genetic factors, lifestyle changes can reduce the likelihood or delay the onset of the condition.
Summary
Insulin resistance is a prevalent condition that is a precursor of type 2 diabetes. People who have a family history of diabetes should always look for insulin resistance and follow healthy lifestyle habits. Maintaining a healthy weight and regular exercise can help manage insulin resistance and reduce the chances of developing type 2 diabetes.