Updated: Feb 14
What is Insulin Resistance?
Insulin resistance happens when your body cells such as your muscle, liver cells and fat cells do not respond properly to the given concentration of insulin. Insulin is a hormone, secreted by your pancreas that helps your cells to uptake glucose from the blood and use it for making energy Therefore, in case of insulin resistance, the cells can’t uptake glucose from your blood effectively to make energy from it. To compensate for this cellular weakness, your pancreas makes more insulin to defeat your escalating blood glucose levels. The result is increased serum insulin that we call hyperinsulinemia. Your pancreas continues working this way for a while to make more insulin and compensate for your cells’ weakness in responding to insulin. So, your blood sugar level stays in a healthy range. However, through time your cells become weaker and as a result they become more resistant to insulin, and your pancreas can not offset your elevated blood glucose levels. This phenomenon translates as prediabetes and type 2 Diabetes.
Is insulin resistance the same as diabetes?
This is an array of disease that starts with resistance to insulin. If you do not pay attention to your increasing blood sugar and the level of insulin chronically stays high, it will progress to prediabetes and ends up to diabetes type 2.
What is prediabetes?
Prediabetes is called when your blood sugar is above normal, but not that high to be diagnosed as diabetes. Prediabetes usually occurs in people who already have some insulin resistance. If the increased blood sugar continues, prediabetes lead to Type 2 diabetes which is the most common type of diabetes.
What is the impact of insulin resistance on your body?
The result of insulin resistance is increased insulin production by beta cells of your pancreas to keep the blood sugar in a normal level. This is called hyperinsulinemia. The elevated levels of insulin can result in inflammation, atherosclerosis, hypertension, weight gain and more. These conditions, in turn, make insulin resistance worse.
Insulin resistance is closely linked to metabolic syndrome, which is a collection of sign and symptoms such as obesity, hypertension, and lipid disorder in addition to insulin resistance. Metabolic syndrome increases risk of cardiovascular disease, stroke, and Type 2 diabetes.
Main presentations of metabolic syndrome include:
You may have one or more of these features.
Elevated blood sugar level.
Elevated serum triglyceride.
Elevated serum LDL cholesterol level
Reduced serum HDL (high-density lipoprotein) (HDL) cholesterol.
What factors increase the risk of resistance to insulin?
· High intake of sugar, carbohydrate food, or high calorie diet
· Over weight / obesity
· Chronic stress
· Sedentary lifestyle
· Sleep disorder
· Polycystic ovary syndrome
· Cushing syndrome
· Prolonged use of steroid
What are the symptoms of insulin resistance?
At the beginning Insulin resistance may have no symptoms. As long as the pancreas increase production of insulin and the blood sugar is maintained in normal level, you may stay asymptomatic.
However, over time, the beta cells of pancreas wear out and production of insulin decreases and leads to elevated blood glucose and symptoms of diabetes appears such as increased thirst, increased in volume and frequency of urine, increased hunger, slow healing of cuts and bruise, skin dryness, blurred vision among many.
Considering the fact that prediabetes can be asymptomatic for years, there are individuals who may develop signs like multiple skin tags, darkening of back and side of the neck and their armpits (called Acanthosis nigricans), fatigue, difficulty concentrating, Weight gain, especially around abdomen, High blood pressure, High cholesterol levels
If you’re experiencing any of these symptoms, you better make a time for yourself to consult with your healthcare provider.
What are the causes of insulin resistance?
There are many factors that can predispose you to insulin resistance. Most of the time the root causes are acquired which means you can have control on them and improve your insulin resistance. These factors include:
· Increased body fat, particularly abdominal fat and obesity.
· Lifestyle; Sedentary lifestyle and lack of physical activity
· Choice of diet; full of refined carbohydrate and saturated fat
· Certain medications; like prolonged use high dose steroids
· Hormonal imbalance; such as increased cortisol (Cushing syndrome, increased growth hormone(acromegaly) and thyroid disorders.
How to diagnose insulin resistance?
Diagnosis of insulin resistance is primarily clinical and then you need medical lab tests to confirm the diagnosis. The fact is, insulin resistance is not easy to diagnose because not only it depends on the individual’s unique condition, but also the level of opposite hormones may differ at the time of testing. Besides, as long as your pancreas is producing enough insulin to overcome the resistance, you won’t have any symptoms.
As a result, there’s no single test that can directly diagnose insulin resistance and your healthcare provider will consider several factors when assessing insulin resistance, including your:
Signs and symptoms.
What are medical lab tests to evaluate insulin resistance?
Your healthcare provider may order a combination of lab tests to diagnose insulin resistance and/or prediabetes or diabetes:
× HbA1C (Glycated hemoglobin A1c)
× Fasting plasma glucose (FPG)
× Oral glucose tolerance test (OGTT)
× Random glucose test
FPG in addition to OGTT reflect blood glucose levels at the time of test
HbA1C is the average blood glucose levels for 3 months prior to the test.
Other conditions to consider that might be associated with insulin resistance are metabolic syndrome, cardiovascular disease and polycystic ovary syndrome (PCOS).
How can you improve insulin resistance?
There are many ways that you can help to improve your insulin resistance such as having healthier diet, lifestyle modifications, increasing your activity and adding some physical activities to your daily routine.
This is short list of the lifestyle adjustment that you can start practicing from today:
· Avoid eating more than you need
· Eat only when you are hungry
· Eat whole food, including vegetables, fruits, whole grains, legume, fish and lean poultry.
· Eliminate refined sugar and processed starches from your diet
· Substitute your diet's fat by healthy fat like avocado, olive oil
· Reduce stress
· Practice some relaxation methods like “Deep Breathing”
· Learn how to improve sleep quality
· Do regular exercise
· Keep an optimum Vitamin D level
· Improve your digestion
· Reduce inflammation by anti-inflammatory nutrients
· Avoid hidden food sensitivities
Over time, your lifestyle modifications show positive results such as:
Reduce insulin resistance and increase insulin sensitivity
Lower your blood glucose levels.
Decrease LDL and increase HDL
The last words!
Stay Motivated! Don’t be discouraged if you feel your expectation are not fully met. Everyone is different and the various methods and tactics for blood sugar adjustment work differently from one individual to the other. You are not alone. Keep in mind that the key is maintaining a healthy weight, exercising regularly, and eating a healthy diet to be able to eventually reduce insulin resistance and improve insulin sensitivity.
If you have any questions about your risk of developing insulin resistance or conditions associated with it, talk with your healthcare provider. We are here to help you.
What will happen when you come for a visit?
The first visit that we call history taking can be in person or virtual (phone or video). During 1 – 1 ½ hours visit, we firstly go over your health concerns one by one and then we take a thorough history from all your organ systems to get a holistic understanding of your condition.
In the second visit which is 30-45 minutes, we do a complete whole body physical examination. Either in first visit or in the second visit we will provide a lab requisition to you.
In your third visit which is usually few days after receiving your lab exam we review the result of lab exam and setup a treatment plan for you.
In each of your subsequent visit, we review what food you are taking, how much, and when you eat. I believe knowledge is the key and during our multiple sessions together, you will learn how the food you eat impacts your health and well-being and how to improve your eating habits to help with your physical and mental health, your night sleep, your ability to think and learn, and your performance in school or at work.
The lab exam and blood draw are done by a lab technician in a life labs center of your choice. However, there is a Lifelabs medical laboratory at 2050 Weston Road, conveniently walking distance to my clinic.
* Disclaimer: The information in this article is property of Dr. Masoumeh Shayesteh Manesh, Naturopathic Doctor and is not intended to diagnose, treat or cure any diseases or promote any products or services mentioned on this website.