Insulin Resistance and Diabetes

Insulin resistance is is becoming quite prevalent, affecting approximately 34% of Americans. This condition is particularly common in individuals with obesity or a family history of diabetes. As rates of obesity and sedentary lifestyles continue to rise, so too does the prevalence of insulin resistance, putting millions at risk of serious health complications, including heart disease.

What is Insulin Resistance?

Insulin is a hormone produced by the pancreas. Its main role is to regulate blood glucose, a key factor in your body’s energy management. When we eat carbohydrates, they are broken down into glucose, which enters the bloodstream. In response to this increase in blood glucose, the pancreas releases insulin. This hormone acts like a key, unlocking cells in muscles, liver, and fat tissue to allow glucose to enter and be used for energy or stored.

In a healthy body, insulin helps maintain stable blood sugar levels, preventing harmful blood sugar spikes that can damage blood vessels, nerves, and other organs. However, when cells become less responsive to insulin's signal, a condition known as insulin resistance occurs.

At first, the pancreas increases insulin production to keep blood glucose levels stable. This increased demand can strain the pancreas, and over time, it may no longer produce enough insulin to overcome the cells' resistance. When blood glucose levels start increasing, this condition can progress to prediabetes and type 2 diabetes.

Factors Contributing to Insulin Resistance

• High Body Weight and Obesity: Excess body fat, especially around the abdomen, can interfere with insulin action.
• Lack of Exercise: Muscles use glucose for energy, so regular physical activity improves insulin sensitivity.
• Genetics: A family history of diabetes can increase the risk of insulin resistance.
• Diet High in Processed Foods and Sugars: A diet rich in refined carbohydrates and sugary foods can lead to frequent blood sugar spikes, increasing the demand for insulin.

Symptoms Insulin Resistance

Insulin resistance often has no noticeable symptoms in its early stages, as it often develops gradually and can go undetected, which makes it challenging to diagnose without blood tests. However, there are some potential signs, including:

• High Blood Sugar: If your fasting blood sugar consistently measures 100 mg/dL or higher after several hours without eating, it may indicate that your body is having difficulty regulating glucose effectively.
• High Triglycerides: Elevated triglycerides, particularly levels of 150 mg/dL or more, can signal metabolic strain associated with insulin resistance.
• High LDL-C Cholesterol : Increased levels of low-density lipoprotein (LDL), commonly known as “bad” cholesterol, often accompany insulin resistance, as do lower levels of high-density lipoprotein (HDL) cholesterol. For males, HDL levels below 40 mg/dL and 50 mg/dL for females are considered lower than preferred.
• Abdominal Obesity: Weight around the waist is a strong indicator of insulin resistance, with measurements over 40 inches in men and over 35 inches in women associated with higher risk.
• Skin Changes (acanthosis nigricans): Dark, thickened patches of skin, usually around the neck, armpits, or groin, may appear with insulin resistance. These patches, called acanthosis nigricans, are often a visible sign of metabolic imbalance.
• High Blood Pressure : Elevated blood pressure, typically 130/80 mmHg or higher, is common among those with insulin resistance.
• A1C Levels Between 5.7%–6.3%: The A1C test measures average blood sugar levels over the past 3 months. This range indicates prediabetes, a stage often associated with insulin resistance.

Diabetes

Diabetes is a chronic condition that affects how your body turns food into energy. There are two main types of diabetes:

• Type 1 Diabetes
  • Autoimmune Disease: In type 1 diabetes, the body's immune system mistakenly attacks and destroys the cells in the pancreas that produce insulin.
  • Insulin Dependence: People with type 1 diabetes must rely on insulin injections or a pump to regulate their blood sugar levels.
• Type 2 Diabetes
  • Insulin Resistance: As discussed earlier, insulin resistance is a key factor in the development of type 2 diabetes.
  • Decreased Insulin Production: Over time, the pancreas may not be able to produce enough insulin to compensate for the body's insulin resistance.

How Insulin Resistance Leads to Diabetes

Insulin resistance is a major factor that leads to prediabetes and, if left untreated, type 2 diabetes.

Insulin helps move glucose out of the bloodstream and into cells where it can be used for energy. With insulin resistance, body’s cells do not respond to insulin as effectively, so more glucose stays in your blood.

To compensate, the pancreas produces more insulin. This works for a while. Overtime, it wears down your pancreas and it is harder to maintain normal blood sugar levels. As this resistance continues, blood sugar levels gradually increase, leading to prediabetes, a condition where blood sugar levels are elevated but not yet high enough for a diabetes diagnosis. Without intervention, prediabetes often progresses to type 2 diabetes.

Keep in mind that insulin resistance is specific to type 2 diabetes and does not cause type 1 diabetes. Type 1 diabetes results from an autoimmune reaction where your body’s immune system mistakenly attacks insulin-producing cells in your pancreas, leading to little or no insulin production. Patients with type 1 diabetes do not have insulin resistance; rather, they need external insulin because their bodies cannot produce it naturally.

The progression from insulin resistance to type 2 diabetes can often be slowed or even reversed with lifestyle changes. Some research shows that losing as little as 5-10% of body weight, eating a balanced diet, and incorporating regular exercise can improve your body’s response to insulin, helping to prevent or delay the development of type 2 diabetes.

Preventing and Managing Insulin Resistance and Diabetes

While there's no cure for diabetes, lifestyle modifications can help prevent and manage both insulin resistance and diabetes:

• Healthy Diet: A balanced diet rich in fruits, vegetables, whole grains, and lean protein can help regulate blood sugar levels.
• Regular Physical Activity: Regular exercise can improve insulin sensitivity and help control blood sugar levels.
• Weight Management: Maintaining a healthy weight can reduce the risk of insulin resistance and diabetes.
• Medication: In some cases, medication may be necessary to manage blood sugar levels.