What is insulin resistance?

September 24, 2022September 24, 2022 M.Khalid

Last Update on September 24, 2022

Medically reviewed by Robin S. Goland, MD

1. Overview:

When cells in your muscles, fat, and liver don’t respond well to insulin and are unable to properly absorb glucose from your blood, this condition is known as insulin resistance. Your pancreas produces more insulin as a result, allowing glucose to enter your cells more easily. Your blood glucose levels will remain within a healthy range as long as your pancreas can produce enough insulin to overcome your cells’ adverse reaction to it.

When the cells in your muscles, fat, and liver do not respond to insulin as they should, you develop insulin resistance, also known as impaired insulin sensitivity. Insulin is a hormone produced by your pancreas that is necessary for life and to control blood sugar levels in the body. Acute or chronic insulin resistance is common, and it is usually treatable.

Your muscle, fat, and liver cells may react wrongly to insulin for a number of reasons, making it difficult to enable them to properly absorb or retain glucose from your blood. It’s called insulin resistance. As a result, in an attempt to control your growing blood glucose levels, your pancreas generates more insulin. It’s known as hyperinsulinemia.

Your blood sugar levels will remain within a healthy range as long as your pancreas can produce enough insulin to counteract your cells’ poor response to insulin. Hyperglycemia, which results from your cells’ excessive insulin resistance, causes raised blood glucose levels (hyperglycemia), which eventually causes pre-diabetes and Type 2 diabetes.

2. Causes of Insulin Resistance:

There are some main causes of insulin resistance:

2.1. Genetic conditions:

For a number of reasons, many inherited genetic disorders (disorders you are born with) might result in insulin resistance.

A spectrum of uncommon illnesses known as inherited extreme insulin resistance syndromes is grouped together in this way. These syndromes are listed from least severe to most severe and include:

Type an insulin resistance syndrome
Rabson-Mendenhall syndrome
Donohue syndrome

The following other related diseases can result in insulin resistance:

Myotonic dystrophy
Alström syndrome
Werner syndrome
Inherited lipodystrophy

2.2. Weight increase:

According to doctors, obesity, particularly excess visceral fat (fat around the organs and in the abdomen), is a major factor in insulin resistance. Insulin resistance is associated with waist sizes of at least 40 inches for men and 35 inches for women. Even if your body mass index (BMI) is within the normal range, this is still true. However, studies have revealed that Asian Americans may be at higher risk for insulin resistance even if their BMI is normal.

2.3. Physical inactivity:

Insulin resistance and diabetes are related to insufficient physical exercise. Your body undergoes changes as a result of regular exercise that improves its control over blood glucose levels.

2.4. Diet:

Insulin resistance has been associated with a diet high in saturated fats, highly processed foods, and carbohydrates. High-processed, high-carbohydrate foods are digested quickly by your body, which raises your blood sugar levels. Your pancreas is under additional strain to generate a lot of insulin as a result, and this might eventually result in insulin resistance.

2.5. Certain medications:

Steroids, some blood pressure drugs, some HIV treatments, and some psychiatric medications are among the drugs that might lead to insulin resistance.

2.6. Hormonal disorders:

Different hormones, which are chemicals that control different physical processes by sending messages to your organs, muscles, and other tissues through your blood, are produced by your body on a daily basis. These messages give your body instructions on what to do and when.

How effectively your body uses insulin can be impacted by problems with specific hormones. The following hormonal conditions can result in insulin resistance:

Cushing’s syndrome
Acromegaly
Hypothyroidism

3. Symptoms of insulin resistance:

Insulin resistance typically has no symptoms. A disease known as acanthosis in Nigerians causes some persons with pre-diabetes to have darker skin under their arms or on the back and sides of their neck. In the same locations, several tiny skin growths known as skin tags frequently form.

Some insulin-resistant individuals may already have early alterations in their eyes that can develop into retinopathy, according to a few study studies, even though blood glucose levels are not high enough to trigger symptoms for the majority of people. Diabetics are more likely to experience this issue.

4. Diagnose insulin resistance:

The following blood tests may be recommended by your doctor to detect insulin resistance, pre-diabetes, or diabetes:

Glucose: Pre-diabetes, type 2 diabetes, and gestational diabetes can all be detected, diagnosed, and/or monitored using fasting plasma glucose (FPG) or a glucose tolerance test (GTT).
Glycated hemoglobin A1c (A1c): Your average blood glucose levels over the last three months are shown by this test.
Panel: This is a series of tests that evaluate the levels of particular lipids in your blood, including triglycerides, LDL cholesterol, HDL cholesterol, and total cholesterol.

Blood tests are used by doctors to determine if a patient has pre-diabetes, but they rarely check for insulin resistance. The most challenging and primarily-used test for insulin resistance is also the most accurate.

To detect pre-diabetes, doctors most frequently utilize the fasting plasma glucose (FPG) test or the A1C test. The oral glucose tolerance test (OGTT), which is more expensive and more difficult to administer, is used less frequently by clinicians.

Your normal blood glucose level over the previous three months is shown by the A1C test. Your blood glucose level at the time of the test is shown by the FPG and OGTT. Compared to other tests, the A1C test is less sensitive. It might not detect pre-diabetes in some persons that the OGTT might. Before your fasting blood glucose level becomes abnormal, the OGTT can help you understand how your body processes glucose after a meal. The OGTT is frequently used by clinicians to detect gestational diabetes, a form of disease that appears during pregnancy.

Within the next five to ten years, people with pre-diabetes had a 50% chance of getting diabetes. By managing your pre-diabetes, you can avoid developing type 2 diabetes.

5. Prevention of insulin resistance:

Your body may respond to insulin effectively if you engage in physical exercise and, if necessary, lose weight. Making modest changes, such as eating better in persons with pre-diabetes, reversing insulin resistance and increasing physical activity can help to delay or prevent the onset of type 2 diabetes.

The Diabetes Prevention Program (DPP), a research project financed by the National Institutes of Health, discovered that for those with a high chance of getting diabetes, decreasing 5 to 7 percent of their beginning weight helped lower their risk of contracting the condition. 3 For a person who weighs 200 pounds, that translates to 10 to 14 pounds. By making dietary changes and increasing their physical activity, the study participants lost weight.

The DPP also indicated that consuming metformin, a medication used to treat diabetes, could postpone the onset of the disease. Women with a history of gestational diabetes, younger individuals, and obese people responded best to metformin. If you think metformin might be right for you, ask your doctor.

You can make lifestyle changes that might prevent or reverse insulin resistance and pre-diabetes by creating a plan, keeping track of your progress, and seeking support from your doctor, family, and friends. As a member of the National Diabetes Prevention Program, you might be able to participate in a lifestyle modification program.

6. Complications:

Insulin resistance is more likely to develop in people with genetic or lifestyle risk factors. Risk elements consist of:

Overweight or obesity
Age 45 or older
Medical history of a family with diabetes
Physical inactivity
Health problems like high blood pressure and abnormal cholesterol levels in the body
A history of gestational diabetes
A history of any heart problem or stroke
Polycystic ovary syndrome

Pre-diabetes is more prevalent in those with metabolic syndrome, which is characterized by high blood pressure, excessive cholesterol levels, and a big waist circumference.

Other elements that may cause insulin resistance in addition to these risk factors include:

Glucocorticoids, some antipsychotics, and medicines for HIV
Cushing’s syndrome, Acromegaly
Sleep apnea

Although risk variables including age, ethnicity, and family history cannot be changed, lifestyle risk factors related to food, exercise, and weight may. You may be able to reduce your risk of pre-diabetes or insulin resistance by making these lifestyle changes.

7. Insulin resistance treatment:

The main treatment for insulin resistance is lifestyle changes because some of the causes of insulin resistance, like genetics and age, cannot be changed. Changes in lifestyle include:

Eating a healthy diet: Your doctor or nutritionist may advise to you take limited harmful fats, sweets, red meats, and processed carbohydrates while avoiding consuming excessive amounts of carbohydrates, which encourage the development of excess insulin. Instead, they’ll probably advise consuming a diet rich in whole foods, which includes more fruits, vegetables, whole grains, fish, and lean meat.
Physical activity: Regular moderate-intensity exercise increases the use of glucose as fuel and enhances muscle sensitivity to insulin. Exercise of moderate intensity can boost glucose uptake by at least 40% in a single session.
Losing excess weight: Your doctor could advise you to try to lose weight in order to try and address insulin resistance. According to one study, 7% weight loss can delay the onset of Type 2 diabetes by 58%.

Medicines: Although there are currently no drugs especially for treating insulin resistance, your doctor may recommend drugs to treat comorbid illnesses. Several instances include:

Blood pressure medication
Metformin for diabetes
Statins to lower LDL cholesterol

These changes in lifestyle over time can:

Increase insulin sensitivity
Lower your blood glucose levels
Decrease blood pressure
Low triglyceride and LDL (“bad”) cholesterol levels in the body
Raise HDL (“good”) cholesterol levels

Along with your primary care physician, you might collaborate with additional medical professionals to develop a personalized treatment plan that is most effective for you. Examples of these professionals include a dietitian and an endocrinologist.