Insulin Resistance: What You Need To Know

You might have heard that diabetes is referred to as insulin-dependent or insulin-resistant. However, the symptoms and suffering of the patients suffering from both variants remain the same. What is it that sets these two apart then? How can one differentiate one from the other?

Insulin is a hormone secreted by the pancreas for glucose absorption and metabolism. Insulin resistance is a condition where people are not able to use circulating insulin effectively as the cells of the body become resistant to insulin. This leads to difficulty in absorbing glucose and the accumulation of sugar in the blood. However, many people who have insulin resistance have high blood sugar levels but not high enough to be labelled as diabetes. This condition is known as the prediabetes stage.

It is not known exactly why one develops it; however, being overweight or obese are high-risk factors for developing this condition. Other factors that may also cause insulin resistance are genetic and lifestyle factors.

Insulin resistance can be temporary or chronic and can be treatable in some cases. Exercise is one of the fastest and the most effective ways to manage insulin resistance apart from oral anti-diabetic and anti-obesity medications which may be prescribed by your physician to manage the condition.

Dr. Ashish Bajaj, M.B.B.S. M.D. in Clinical Pharmacology and Toxicology

Effects of Insulin Resistance:

Insulin resistance initially does not trigger any symptoms. You may be insulin resistant and may not even realize it at all. Sometimes a simple blood glucose test too cannot tell you if you are insulin resistant or not.

The earliest signs and symptoms of insulin are weight gain, particularly around the waistline, which is termed central obesity. A person typically has a fat waistline, a big belly, a fat and thick neck, a double chin, and a fatty hump at the back of the neck but relatively thin arms and legs.

Another symptom that people with insulin resistance have is ‘acanthosis nigricans’. This condition causes dark, thick skin patches in the skin folds like the groin area, armpits, and neck. This condition has no cure. Treating the underlying cause, might lighten the color and cause the natural skin colour to reappear, but chances are rare.

Other Insurance Resistance Symptoms Include:

• Lethargy
• Hunger
• Difficulty concentrating
• High blood pressure
• Insulin resistance increases your risk of developing heart disease and stroke.
• Insulin resistance increases your chances of developing Type 2 diabetes in the near future. Classical diabetic symptoms include:
• Increased thirst and hunger
• Hungry even after eating food
• Increased urination more so at the night
• Tingling numbness in the hands or feet
• Unusual exhaustion

Central obesity is the major cause of insulin resistance. Which can further lead to high blood pressure, prediabetes etc (known as metabolic syndrome).Life style changes can prevent metabolic syndrome and further prevent any chronic life style diseases

Dr. Nikhil Yadav, MBBS MD, CCEBDM

Insulin Resistance Causes:

The exact cause for insulin resistance is not known; however, the primary cause has been linked to obesity and being overweight. Excess fat accumulation around the belly causes the fat cells to be deprived of oxygen which ultimately kills them. An inflammatory reaction is set which starts the insulin resistance in the body.

Insulin resistance is identified as an impaired biologic response to insulin stimulation of target tissues, primarily the liver, muscle, and adipose tissue. Insulin resistance impairs glucose disposal, resulting in a compensatory increase in beta-cell insulin production and hyperinsulinemia. Commonest causes include Obesity, overweight, PCOS.

Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)

Is It Reversible?

Losing weight can help reduce the extent of insulin resistance and thereby improve glucose metabolism in the body. This includes a radical shift in dietary and lifestyle habits. The diagnosis of insulin resistance is only a warning signal. It can very often be reversed by adopting healthy lifestyle habits.

Insulin Resistance Tests:

1. The best test to conclude would be HbA1C which tells us about the average blood sugar levels over three months.

• A1C under 5.7 % is considered normal.
• A1C between 5.7%and 6.4% is a prediabetic stage.
• A1C above 6.5% is diagnostic for diabetes.

2. A fasting blood sugar test would also be advised for checking actual blood sugar levels.

3. A fasting blood sugar test and a series of blood glucose tests after a glucose drink (the glucose tolerance test) along with actual quantification of corresponding blood insulin levels is the most accurate test to confirm insulin resistance at an early stage. A fasting serum insulin level greater than 25mIU/L (or 174pmol/L) is considered insulin resistance. The same levels apply three hours after the last meal/ glucose drink.

How to Manage Insulin Resistance in Daily Life

Living with insulin resistance can be rather difficult but it is not altogether impossible. One of the many treatments for insulin resistance begins at home by altering your lifestyle habits as mentioned above. These are:

1. Exercise

Exercise is a universally recommended lifestyle habit for all people. A religious exercise routine of 30-60 minutes can be the solution for many of the health problems in the world including insulin resistance. Insulin resistance helps sugar move into muscles that go into storage and immediately gives a boost to insulin sensitivity.  

Resistance training either done with the help of resistance bands or dumbbells or kettlebells has been found to be very effective against insulin resistance.  

Contrary to popular belief, you may not be necessarily diabetic in order to suffer from insulin resistance. So, doing a combination of resistance training and aerobic training can significantly reduce your insulin resistance especially, when tracked over a 3-month period.  

2. Sleep

Sleep is a highly compromised lifestyle element but a very important one in determining your overall health. Lack of sleep or poor quality of sleep can make you susceptible to health complications such as type 2 diabetes, heart diseases and an array of infections over time. Many studies have been able to successfully establish a connection between increased insulin resistance and low levels of sleep.  

3. Stress

Stress is another silent killer responsible for aggravating many health conditions in people around the world. Not only does chronic stress mess up your mental health but also takes a toll on your physical health.  

Stress is harmful because it triggers the release of the hormones glucagon and cortisol into the body which prompts the body to go into either a fight or flight mode. These two hormones break down the stored sugar and glycogen into glucose which enters one’s bloodstream as a quick form of energy for use by the body.  

Ongoing stress will keep your stress hormones on alert leading you to nutrient breakdown and increased blood sugar. Stress hormones will become you more insulin resistant thus, it is crucial that you keep your stress levels to a minimum by following the below-mentioned tips:

• Exercise every day as it helps to release happy hormones  
• Practice meditation and breathing exercises  
• If you are going through a stressful time, ensure to get proper sleep and nutrition
• Go out for a walk amidst nature either alone or with a loved one  
• If you have recently bounced back from a stressful time, take a break and go on a short trip or weekend trip with your loved ones for rejuvenation  
• Explore the option of music therapy every day for 15-30 minutes
• Speak to a therapist or a friend, do not bottle up your stress

4. Follow a Healthy Diet

• Maintaining a nutritious and filling diet every day is mandatory for a healthy lifestyle and keeping your insulin levels under check. To do this, here are some things you need to do:
• Incorporate insoluble fibre to bulk up your stools and soluble fibre to curb hunger pangs and reduce cholesterol. These foods are oatmeal, legumes, oranges and flaxseeds
• Eat at least two servings of fruits and veggies each day to boost your immunity  
• Carbs are responsible for causing a spike in insulin levels, so, you need to cut down on carbohydrate intake.   You can need to eat smaller portions of carbs and focus on sources high in a glycemic index such as quinoa, brown rice, whole-wheat pasta, sweet potatoes, multigrain brown bread and so on.  
• Reduce your consumption of added sugars by completely omitting processed and packaged foods such as ice cream, cakes, cookies, candies, and aerated drinks.  
• Include herbs and spices in your daily meals such as turmeric, garlic, ginger, cinnamon, black pepper and fenugreek which have many medicinal properties and show good results in increasing insulin sensitivity.

5. Weight

When you suffer from insulin sensitivity irrespective of whether you have type 2 diabetes or not, you need to focus on losing a few pounds for your own health benefit., when starting on your weight loss journey, be sure to focus especially on belly fat reduction which has been found to be directly linked with insulin resistance.  

Insulin is a hormone that is responsible for many bodily functions and so you need to be extra careful when you develop insulin resistance. By following the simple lifestyle changes mentioned above, you can improve your insulin sensitivity significantly in a short amount of time. Additionally, do not neglect your doctor’s advice and prescribed medications (if any).  

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Links and product recommendations in the information provided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.

3

1