What is Insulin Resistance?

What is insulin resistance?

Insulin produced by our body is a hormone that helps to keep the glucose level in the blood under control. The blood that contains the glucose will now enter the organs, cells and muscles that need glucose and are used for energy.

Glucose is obtained from the food we eat, and when the body does not get enough glucose from the food we eat, the liver helps in the process of making the glucose our body needs.

When there is an increase in the blood glucose level, the pancreas releases the hormone insulin in the body to keep the blood glucose level in control.

Insulin resistance happens when the liver, muscles and other organs cannot use the produced insulin from the blood stream. As a result of which, there will be increased production of insulin to help the cells take up the glucose from the bloodstream.

Causes of insulin resistance

Insulin resistance can occur in anyone, and it is not necessary that a person should have diabetes. Sometimes, insulin resistance can be due to some medications like steroids. The common causes of insulin resistance are discussed below.

Excess body fat

Body fat reduces the responsive nature of the cells and organs to take up the glucose from the blood. The excess fat deposition, especially around the belly, can cause insulin resistance.

Overconsumption of foods that contain saturated fatty acids can reduce the affinity of cells to bind to glucose. And also increases the risk of diabetes.

Physical inactivity

Physical inactivity can reduce the responsiveness of the cells to the glucose in the blood. According to research published in NCBI, stated that there are evidences that support the link between physical inactivity and insulin resistance.

People with sedentary lifestyles have an increased risk of getting affected with type 2 diabetes mellitus. When a sedentary lifestyle prolongs, people can develop diabetes even in their early 20s and 30s.

Diet

Diet plays a major role in insulin dependency. Foods that contain saturated fats and trans fats can increase the risk of developing insulin resistance.

Fried foods and animal-based foods are high in saturated and trans fats. Foods that are fried in partially hydrogenated oil, soda, sweetened fruit juices and iced teas can make you gain weight and also increases the risk of type 2 diabetes mellitus.

Certain medications

Medication use can cause temporary insulin resistance. Medications like steroids, medications used for HIV treatment and psychiatric medications can cause insulin resistance. Mostly these medications can have a temporary effect. However, some drugs can cause a permanent effect.

Hormonal disorders that can cause insulin resistance

Hormonal disorders can cause insulin resistance. When the body undergoes certain changes, it can lead to insulin resistance. Lifestyle can have a direct link to hormonal disorders.

Cushing’s syndrome

Cushing’s syndrome is a benign tumour that occurs in the pituitary gland. It makes the pituitary gland produce extra cortisol also called as the stress hormone.

The cortisol hormone regulates the production of blood glucose levels which increases the production of glucose. This can lead to type 2 diabetes.

When there is an excess cortisol level in the blood, it can counteract the effect of insulin, which can lead to insulin resistance.

Acromegaly

Acromegaly is a hormonal disorder that causes increased production of growth hormones. This caused due to the malfunctioning of the pituitary gland. This can lead to increased bone size and height. As a result, it leads to gigantism.

This can impair the insulin sensitivity of the liver, which reduces the ability to use insulin and causes insulin resistance.

The growth hormone stimulates the expression of key enzymes involved in the process of gluconeogenesis. As a result, there will be increased production of glucose. This will induce an insulin insensitivity directly or indirectly, which leads to insulin resistance.

Hypothyroidism

Hypothyroidism alters glucose metabolism and can lead to insulin resistance. Hypothyroidism leads to metabolic abnormalities and can increase blood glucose levels.

Symptoms of insulin resistance

When a person has insulin resistance, the pancreatic cells increase the production of insulin, and the person will not have any symptoms. But over time, the pancreatic cells can wear out due to the overproduction of insulin, and the person will experience certain symptoms. Some of the common symptoms are briefed below.

Acanthosis nigricans

Acanthosis nigricans is a condition of dark and think skin. It is mainly seen in folds and creases of the skin like the neck, armpit and groin. People who are obese are commonly affected by this condition.

The presence of acanthosis nigricans can be a symptom of insulin resistance which can lead to type 2 diabetes.

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome is a common hormonal disorder among women. Women affected by polycystic ovary syndrome have prolonged and painful periods. Their menstrual cycle will also be infrequent.

Polycystic ovary syndrome can also indicate that a person is affected by insulin resistance. Both polycystic ovary syndrome and acanthosis nigricans can be related to insulin resistance.

Vascular disease

There are evidences of insulin resistance and cardiovascular diseases. People affected with insulin resistance, their body can induce an imbalance in glucose metabolism. This imbalance generates chronic hyperglycemia.

As a result, it triggers oxidative stress and causes an inflammatory response that leads to cell damage. This can lead to cardiovascular diseases and also alters the signal transduction pathways.

Major depressive disorder (MDD)

Major depressive disorder (MDD) or depression is a disorder that affects mental health. It makes people lose interest in every work and have a feeling of persistent sadness. It affects the quality of life and affects people with emotional and physical problems.

People affected by this disorder will have trouble leading a normal life. At times, they will feel worthless of their life and have many suicidal thoughts. The disorder requires long-term treatment.

People affected with this disorder will have a sudden outburst of anger and irritability, even for small matters. Appetite reduces or increases cravings for food. Loss of appetite can lead to weight loss, and they will also have anxiety and restlessness issues.

According to research conducted by Stanford Medicine scientists, depression can be a symptom of insulin resistance or vice versa.

Extreme thirst or hunger

Sometimes you would have just consumed food, but you will feel hungry very often. This is because the muscles did not get energy from the food you ate. The body will keep the glucose from entering muscles and provide the energy required for the functioning of the muscles.

As a result, the muscles and other tissues send a hunger message to the brain. This can lead to extreme hunger or thirst.

Feeling hungry even after a meal

Feeling hungry even after a meal may be due to an insufficient supply of glucose to the tissues and muscles. Due to the body’s insulin resistance, extra energy is required to reach the muscles and tissue.

So people tend to eat more. As a result, they feel hungry very often, even if they just have a snack or a meal. This is one of the common symptoms of insulin resistance.

Increased or frequent urination

Increased urination is one of the common symptoms of diabetes or prediabetes. People tend to urinate often when there is the presence of unused glucose in the blood.

The body tries to eliminate the excess glucose through urine. So people have the feeling to urinate often.

Tingling sensations in hands or feet

People experience a tingling sensation when there is excess glucose in the blood. This can lead to poor circulation of blood and can also damage the nerves. Such symptoms can cause significant damage to the body.

Feeling more tired than usual

Insulin resistance can sometimes cause subtle symptoms. It will not be very obvious and can slowly make a person tired without them realising it. Some people may relate it to not getting enough sleep and consuming unhealthy foods. But the underlying reason may be due to insulin resistance.

Frequent infections

People with insulin resistance are prone to frequent infections. This is because they have reduced blood circulation and nerve damage issues. As a result, this can increase the infection rate of the person.

Evidence of high blood sugar levels in blood work

After experiencing such symptoms, it is advisable to get checked for a blood glucose level. If there is an elevated glucose level, then the person might have diabetes. And it is important that the person take necessary medications to keep the blood glucose level under control.

Diagnosis of insulin resistance

Some of the common diagnosis for insulin resistance are discussed below. However, each diagnostic method has its own accuracy.

A1C test

The A1C test has other names like haemoglobin A1C or HbA1c test. It is a blood test that measures the average of three months period.

The HbA1c is a common blood test used to diagnose prediabetes and diabetes. This test is useful for healthcare professionals to treat and manage the symptoms of the affected individual.

The A1C test gives the percentage of red blood cells that are coated with sugar. When glucose enters the bloodstream, it gets attached to red blood cells— a protein that the human body has. The A1C test concentrates on the sugar-coated RBCs and measures the blood glucose level.

If a person has a percentage of 5.7 and below their, blood glucose level is considered to be normal. If a person has a percentage in the range of 5.7–6.4, the person is considered to be prediabetes. If a person has more than 6.5%, the person is considered to be diabetic.

Fasting blood glucose test

A fasting blood glucose test measures the glucose level in an empty stomach. Before a person can eat, the blood glucose is tested after overnight fasting.

The blood is drawn from the person early in the morning before eating. If the test indicates a level of 99 mg/dL or below, the blood glucose level is considered to be normal.

If the blood glucose level is in the range of 100–125 mg/dL, the person is considered to be prediabetes and if the blood glucose level is higher than 125 mg/dL, the person is considered to be diabetic.

Glucose tolerance testing

The glucose tolerance test measure the blood glucose level before and after a person could drink a liquid that contains glucose. The diagnostic method is to fast before drawing blood from the person. Usually, it is overnight fasting.

After the overnight fasting, the person is administered a glucose liquid. The blood glucose level is tested after one hour, 2 hours and 3 hours.

If the test results indicate a blood glucose level of 140 mg/dL or lower, it is considered a normal range. If the person has a blood glucose level in the range of 140–199 mg/dL, it can indicate that the person has prediabetes, and if it is above 200 mg/dL, it indicates that the person is diabetic.

Random blood draws

The random blood sugar test measures the blood glucose level at the given time. This test does not require any fasting period or specific time to be tested. The blood is drawn at any time and tested for blood glucose levels.

If the blood glucose level is 200 mg/dL or higher than 200 mg/dL indicates that the person is diabetic. The test result can be less accurate when compared to other diagnostic methods.

Treatment of insulin resistance

There are no direct treatments for insulin resistance. However, there are certain ways to manage the symptoms and make them more insulin sensitive.

Exercise

Exercise plays an important role in insulin resistance. Make it a habit to work out daily. This will help you to be active and keeps a check on your blood glucose level.

Get to a healthy weight

Maintaining a healthy weight is important to make the cells become insulin sensitive. It can be achieved with a healthy diet and a workout plan. If you have an unhealthy weight, make sure you shed those extra calories you gained.

Eat a healthy diet

A healthy diet is important to prevent the cells from being insulin resistant. Consume a balanced diet with fruits, vegetables and proteins. This will help you to maintain a healthy weight.

Take medications

Medication can be prescribed by the doctor to keep your blood glucose in check. Do not forget to take those medications.

Complications of insulin resistance

Insulin resistance can be associated with certain complications and is listed below.

Severe high/Low blood sugar

When a person is affected with insulin resistance, the person may have a complication of high or low blood glucose level.

Heart attack

Insulin resistance can have a major complication that can lead to heart-related problems. High blood glucose levels can lead to low blood circulation and block the major arteries, which can cause a heart attack.

Stroke

According to research published in NCBI, it stated that insulin resistance increases the risk factor of stroke.

Kidney disease

Insulin resistance can lead to kidney diseases and other metabolic syndromes. However, it is unclear whether the insulin resistance directly or indirectly contributes to kidney diseases.

Eye problems

Insulin resistance can cause nerve damage, which can affect the nerves in the eyes. If the blood glucose level is not under control, it can cause partial or full blindness.

Cancer

Insulin resistance causes the deposition of fat cells and makes it more difficult for the body to break down. This can lead to hormonal imbalance and inflammation of the cells, which can increase the risk of cancer.

Alzheimer’s disease

People affected with insulin resistance have an increased risk of getting affected with Alzheimer’s disease.

Risk factor of insulin resistance

Having overweight or obesity

If a person is obese or overweight, it can increase the risk of insulin resistance.

Leading a sedentary lifestyle or one that is low in exercise

A sedentary lifestyle can increase the risk of insulin resistance.

Smoking

Smoking can have a significant effect on insulin resistance.

Consuming large amounts of alcohol, which can impact the liver

Overconsumption of alcohol can increase the risk of insulin resistance.

Experiencing sleep issues

When a person has a disrupted sleep cycle or alters their sleep cycle, it can increase the risk of insulin resistance.

Having high cholesterol levels

Consumption of fatty foods can increase cholesterol levels which can mask the insulin sensitivity of the cells and tissues.

Having high blood pressure

High blood pressure or hypertension can alter insulin sensitivity, and the cells can become less sensitive to insulin.

Conclusion

Insulin resistance is more of a lifestyle-related disorder. It can lead to diabetes if it is not overlooked properly.

Physical activity with a healthy diet can increase the sensitivity of the cells and keeps a check on your glucose levels.

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