What is insulin resistance? What are the precursors to diabetes ? What is the difference between diabetes and insulin resistance? How do I know that I suffer from insulin resistance?
What is insulin?
Insulin is a hormone secreted by the pancreas that helps blood glucose enter muscle cells, fat, and the liver, where it is used for energy, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health in United State.
Glucose comes from the food we eat. The liver also produces glucose in times of need such as fasting. When levels of glucose in the blood, also called blood sugar, rise after eating, the pancreas releases insulin into the blood. Then insulin lowers blood glucose to keep it in a normal range.
What is insulin resistance?
Insulin resistance occurs when cells in muscle, fat, and liver do not respond well to insulin and cannot easily absorb glucose from the blood. As a result, the pancreas produces more insulin to help glucose enter the cells. As long as the pancreas can produce enough insulin to overcome the cells' poor response to insulin, blood glucose levels will remain in the healthy range.
What are the precursors to diabetes?
Prediabetes means that your blood glucose levels are higher than normal, but not high enough to be diagnosed with diabetes. Prediabetes usually occurs in people who already have some insulin resistance, or whose beta cells in the pancreas don't produce enough insulin to keep blood sugar levels in the normal range. Without enough insulin, the extra glucose stays in your bloodstream instead of getting into your cells. Over time, you can develop type 2 diabetes.
Who is more likely to develop insulin resistance or prediabetes?
People with genetic or lifestyle risk factors are more likely to develop insulin resistance or prediabetes. Risk factors include:
Being overweight or obese.
Age 45 or older.
A parent, brother or sister with diabetes.
Physical inactivity;
Health conditions such as high blood pressure and abnormal cholesterol levels.
Having a history of gestational diabetes.
A history of heart disease or stroke.
Polycystic ovary syndrome.
People with metabolic syndrome, a combination of high blood pressure, abnormal cholesterol levels, and a large waist size, are more likely to develop prediabetes.
Certain medications, such as glucocorticoids and some antipsychotics.
Hormonal disorders, such as Cushing's syndrome.
Sleep problems, especially sleep apnea.
Causes of insulin resistance and prediabetes
Researchers do not fully understand the causes of insulin resistance and prediabetes, but they believe that excess weight and lack of physical activity are major factors.
Excess weight and insulin resistance
Experts believe obesity, especially excess fat in the abdomen and around the organs, called visceral fat, is the main cause of insulin resistance. A waist measurement of 40 inches or more for men and 35 inches or more for women is associated with insulin resistance. This is true even if the body mass index (BMI) is within the normal range.
Researchers used to think that adipose tissue was just meant to store energy. However, studies have shown that belly fat makes hormones and other substances that can contribute to chronic or long-term inflammation in the body.
Physical inactivity and insulin resistance
Inadequate physical activity is associated with insulin resistance and prediabetes. Regular physical activity causes changes in your body that make it better able to keep blood glucose levels in balance.
How do I know that I suffer from insulin resistance?
Usually there are no symptoms of insulin resistance.
What is the difference between diabetes and insulin resistance?
Insulin resistance is a description of how cells in muscle, fat and liver don't respond well to insulin, which can't easily absorb glucose from the blood.
As for diabetes, it is a chronic disease that occurs when the pancreas is unable to produce enough insulin, as occurs in type 1 diabetes, or when the body is unable to effectively use the insulin it produces (as a result of insulin resistance).
Symptoms of insulin resistance and prediabetes
Usually there are no symptoms of insulin resistance and prediabetes. Some people with prediabetes may have darker skin in the armpits or on the back and sides of the neck, a condition called acanthosis nigricans. Many small skin tags often appear in these same areas.
Although blood glucose levels are not high enough to cause symptoms for most people, some research has shown that some people with prediabetes may actually have early changes in their eyes that can lead to retinopathy. This problem often occurs in people with diabetes.
Diagnosing insulin resistance and prediabetes
Doctors use blood tests to find out if someone has prediabetes, but they do not usually test for insulin resistance. The most accurate test for insulin resistance is complex and is mostly used for scientific research.
Doctors often use the fasting glucose (FPG) test or the HbA1c test to diagnose prediabetes. Often, doctors use the oral glucose tolerance test (OGTT), which is more expensive and not easy to provide.
The cumulative sugar test reflects your average blood glucose over the past three months. The fasting glucose and the oral glucose tolerance test show the level of glucose in the blood at the time of the test.
People with prediabetes have a 50% risk of developing diabetes within the next five to 10 years.
These readings indicate that a person has prediabetes
Cumulative sugar: from 5.7% to 6.4%.
Fasting glucose: 100 to 125 milligrams per deciliter.
Oral glucose tolerance test: 140 to 199 milligrams per deciliter.
You should be tested for prediabetes if you are overweight or obese, have one or more other risk factors for diabetes, or if your parents, siblings or children have type 2 diabetes. Even if you don't have risk factors, you should start getting tested as soon as you reach the age of 45.
If the results are normal but you have other risk factors for diabetes, the test should be retested at least every 3 years.
What is the treatment of insulin resistance in the body?
Physical activity and weight loss may help your body respond better to insulin. Taking small steps, such as eating healthy foods and moving more to lose weight, can help reverse insulin resistance and prevent or delay type 2 diabetes in people with prediabetes.
A research study funded by the National Institutes of Health showed that for people at risk of developing diabetes, losing 5% to 7% of their starting weight helped reduce the risk of developing the disease.
Metformin and the treatment of insulin resistance
The study also showed that taking metformin, a drug used to treat diabetes, can delay diabetes. Metformin worked best for women with a history of gestational diabetes, and for young adults and people who were obese. Ask your doctor if metformin is right for you.
For its part, the German Diabetes Association says that, in addition to drug treatment, insulin resistance can be faced by following a healthy diet based on fresh vegetables, fruits and whole grains, avoiding fats and sweets, maintaining exercise and motor activities, and quitting smoking.
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