Insulin resistance: Everything you need to know

Insuline resistance can cause diabetes

The story of diabetes and insulin resistance are two sides of the same coin. In fact, the underline cause of type 2 diabetes is insulin resistance.

According to the Internation Diabetes Federation, the disease is quite common, and 537 million adults are living with diabetes globally.   

Insulin resistance can be temporary or chronic, but in either state, this health problem is a warning sign of other diseases such as diabetes mellitus.

That is why it is crucial to get to know all the necessary information about insulin resistance and diabetes which we explain in this article.

What is insulin resistance?

Insulin resistance is the condition in which cells in different body parts, particularly, muscles, liver, and fats, fail to respond to insulin.

This impairs the process of glucose uptake from blood to cells thus leading to elevated blood glucose levels.

As a result, the pancreas produces more insulin to balance the glucose levels. This condition is known as hyperinsulinemia.

According to NIDDK, people with insulin resistance or whose pancreas is not making enough insulin are more likely to get prediabetes.

Prediabetes is a condition when blood glucose levels are high but not elevated to categorise diabetes. 

Difference between insulin resistance and diabetes?

There is a common question: Does insulin resistance cause diabetes or does insulin resistance means diabetes?

Insulin resistance is the underlying cause for blood glucose levels to increase above the normal range.

Prediabetes can be prevented by lifestyle modifications, but if preventive measures are not taken, it will progress to full-blown diabetes.  

On the other hand, diabetes mellitus is a chronic, metabolic disease resulting in the persistent elevation of blood glucose. Once it progresses to diabetes, it cannot be reversed.  

In insulin resistance, the amount of insulin in the blood is more than normal. However, in diabetes, the insulin levels can either be above (hyperinsulinemia) or below the normal range.

Causes of insulin resistance 

Insulin resistance is now becoming more prevalent. 

The commonest cause is obesity. Evidence suggests that in obesity, the fat tissue release some inflammatory molecules, which contribute to the impairment of insulin signalling.

It is suggested that this condition begins in the muscle tissues in which impaired glucose uptake causes returns of the glucose to the liver.

In the liver, excess glucose resulted in increased lipogenesis thus causing a rise of circulating fatty acids leading to fat deposition in the body. Fat deposition typical occurs in the liver and around the organ. This condition is known as central obesity. 

A sedentary lifestyle, family history, certain medicines, excessive alcohol consumption, and smoking contribute to this condition. 

What are the risk 

Insulin resistance results in initiating significant metabolic changes in the body.

It gives rise to the development of diabetes (hyperglycaemia), hypertension, dyslipidemia, fat deposition around viscera (also known as central obesity), elevated inflammatory markers, and endothelial dysfunction.

Progression of insulin resistance causes the development of metabolic syndrome, nonalcoholic fatty liver disease (NAFLD), and type 2 diabetes mellitus.

All these metabolic conditions increase the risk of developing heart attack (myocardial infarction) and stroke thus increasing the risk of dying early.

Features of insulin resistance

Unfortunately, there are no or few signs in the early stage of the condition. It is very difficult to find it by a physical examination in the beginning. 

When you start putting on weight, and your BMI goes to the high-risk zone (above 25 kg/m2), it is a warning sign. Positive family history of diabetes gives you clue. 

Dark, velvety patches can be on the neck, armpits, and groin. This condition is known as Acanthosis nigricans,  and it is an indication of an underline serious condition such as diabetes. 

A blood sugar test can give an idea about what is happening in the body. You are at risk if your fasting blood sugar is more than 100 mg/dl. 

When these risk factors are there, meet your healthcare provider for further assessment. Elevated blood pressure (more than 140/90 mmHg) and high serum triglyceride indicate that there is underline insulin resistance. 

Prevention and treatment 

Fortunately, positive lifestyle measures can effectively be used to treat and prevent this deadly condition. The most effective lifestyle changes that can be tried are, 

  1. Stay physically active. A sedentary lifestyle and lack of physical exercise are key contributing factors. Try to engage in at least 30 min of moderate-intensity exercises at least 5 days a week. That counts as 150 min of exercise per week. If you are doing vigorous exercises, 75 min per week is sufficient. 
  2. Opt for whole meals and complex carbs. These types of diets are low in glycaemic index and have a slower rate of glucose absorption in the small intestine. In addition, they are rich in fibres which have numerous benefits including slowing down of glucose and fat absorption. 
  3. Get rid of simple sugars. Refines simple sugars are abundant in cake, ice creams, doughnuts, chocolates, and many other sweets. When consumed these can give rise to a rapid rise in blood sugar and subsequent secretion of insulin. Ultimately this glucose is converted to fats and stored as fats. Over time you will become obese.  

The time it takes to reverse insulin resistance depends upon the severity of the condition and the efforts you have put in. 

The Bottom Line

This condition occurs due to decreased sensitivity of cells to insulin.

Insulin resistance is different from diabetes, and it is, in fact, the underline cause of diabetes. However, this condition can develop into prediabetes and subsequently into type 2 diabetes.

Fortunately, positive lifestyle measures such as exercise and a healthy diet can possibly prevent and reverse it.

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