Insulin Resistance
According to the National Health and Nutrition Examination Survey, 40% of U.S. adults, ages 18-44, have insulin resistance (IR). While the cause of IR is a bit of a medical mystery, the potential outcomes are not. IR is a precursor to serious health conditions such as diabetes which can lead to potentially fatal cardiovascular events, including a heart attack or stroke.
What is insulin resistance?
Insulin resistance occurs when the body's cells do not respond properly to insulin, a hormone that helps regulate blood sugar levels. When IR develops, the transition of sugar from the bloodstream into cells for energy gets disrupted. The sugar that remains in the bloodstream raises glucose levels and can lead to conditions such as prediabetes and type 2 diabetes.
What causes insulin resistance?
While it is not fully understood why IR occurs, certain genetic and lifestyle factors are known to contribute to its development. In some cases, addressing these factors can help improve IR. However, once IR develops, it becomes a long-term condition that needs to be managed to reduce risks of complications by maintaining blood sugars in the normal range.
Symptoms
Insulin resistance often develops silently, but certain symptoms and signs may indicate its presence:
- Low energy levels, especially after eating
- Hunger soon after meals and cravings for sugar or carbohydrates
- Weight gain, particularly around the abdomen
- Skin changes like a rash called Acanthosis nigricans, a darkened, velvety skin patch in areas like the neck or armpits, or skin tags
- High blood pressure (above 130/80 mmHg)
- Elevated triglycerides and low HDL ("good") cholesterol levels
Genetics
- Having a parent or sibling with type 2 diabetes
- Being of certain ethnicities, such as African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American
Lifestyle
- Being overweight or obese, especially around the belly
- Being physically inactive
- Smoking
- Poor sleep habits
- Taking certain medications, such as steroids, anti-psychotics, and HIV medication
Health conditions
- High blood pressure
- High triglycerides
- High LDL (bad) cholesterol
- Low HDL (good) cholesterol
- History of gestational diabetes
- History of heart disease or stroke
- Polycystic ovary syndrome (PCOS)
- Obstructive sleep apnea (OSA)
- Fatty liver disease
- Cushing's syndrome
Diagnosing insulin resistance involves assessing symptoms alongside laboratory tests. Common diagnostic methods include:
A1c test to determine your average blood sugar levels over the past 3 months.
Fasting blood sugar test to measure your blood sugar levels after not eating overnight.
Oral glucose tolerance test to measure the body’s response to glucose. Commonly used to check for diabetes during pregnancy
Additional factors considered when making a diagnosis include:
- waist circumference (above 40 inches for men or 35 inches for women)
- high triglycerides (over 150 mg/dL)
- low HDL cholesterol (below 40 mg/dL in men or 50 mg/dL in women
There is no cure for insulin resistance (IR), but there are things you can do to make your cells more sensitive to insulin.
Be active: Because exercise stimulates muscles to take up more glucose from the bloodstream, it’s an effective way to reduce the risk of IR.
Lose weight: Excess body fat can contribute to worsening insulin resistance. Losing weight/fat mass can improve IR.
Eat well: Research suggests that eating foods low in fat and high in carbohydrates can worsen IR. Diets rich in non-starchy vegetables, fruits, whole grains and lean proteins can work to reduce your blood sugar and reverse insulin resistance.
Get enough sleep: Studies have found insufficient sleep can contribute to IR. Strive for at least seven hours per night.
Medication: There are no FDA-approved medications for treating IR. However, some diabetes medications (metformin and thiazolidinediones) work to lower blood sugar. Talk to your doctor about whether these medications are appropriate for you.
Manage associated health conditions: Speak with your doctor about diagnosing and treating coexisting OSA, fatty liver disease, cholesterol abnormalities, Elevated blood pressure.
Stop Smoking: If you are currently smoking, quitting will decrease risk of heart attack and stroke along with maintaining good blood sugars.
Stress management: Studies have linked stress and insulin resistance. Practice mindfulness techniques, be active, and practice other stress relieving strategies.
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