Insulin Resistance | Dr Ashwani Kansal

 

 

Insulin Resistance

Insulin resistance is when cells in your muscles, fat, and liver don’t respond well to insulin and can’t use glucose from your blood for energy. To make up for it, your pancreas makes more insulin. Over time, your blood sugar levels go up.

 

Insulin resistance syndrome includes a group of problems like obesity, high blood pressure, high cholesterol, and type 2 diabetes. It could affect as  metabolic syndrome.

 

Symptoms of Insulin Resistance

You can't tell that you have insulin resistance by how you feel. You'll need to get a blood test that checks your blood sugar levels.

 

if you have most of the other conditions that are part of insulin resistance syndrome (high blood pressure, low "good" cholesterol levels, and high triglycerides) without seeing your doctor.

 

Some signs of insulin resistance include:

 

A waistline over 40 inches in men and 35 inches in women

Blood pressure readings of 130/80 or higher

A fasting glucose level over 100 mg/dL

A fasting triglyceride level over 150 mg/dL

A HDL cholesterol level under 40 mg/dL in men and 50 mg/dL in women

Skin tags

Patches of dark, velvety skin called acanthosis nigricans

Risk Factors and Causes of Insulin Resistance

Things that can make this condition more likely include:

 

Obesity, especially belly fat

Inactive lifestyle

Diet high in carbohydrates

Gestational diabetes

Health conditions like nonalcoholic fatty liver disease and polycystic ovary syndrome

 

A family history of diabetes

Smoking

Ethnicity -- it’s more likely if your ancestry is African, Latino, or Native American

Age -- it’s more likely after 45

Hormonal disorders like Cushing’s syndrome and acromegaly

Medications like steroids, antipsychotics, and HIV medications

Sleep problems like sleep apnea

Diagnosis and Tests for Insulin Resistance

Your doctor will use these things to diagnose insulin resistance:

 

family's medical history.

 

Physical exam. Check weight/Abdominal Girth/Height  and check your blood pressure.

Blood tests. You might get:

Fasting plasma glucose test. This test measures your blood sugar after you haven’t eaten for at least 8 hours.

Oral glucose tolerance test. First, you'll take the fasting glucose test. Then you'll drink a 70 gm sugary solution. Two hours after that, you'll take another blood test.

Hemoglobin A1c test. This blood test shows your average blood sugar level for the past 2 to 3 months. Use it to diagnose prediabetes or diabetes. If you have diabetes, it helps show whether it's under control. You may need to take the test again to confirm the results.

Serum Insulin fasting

HOMA IR

Lipid profile

 

*How Insulin Resistance Progresses to Type 2 Diabetes

When you have insulin resistance, your pancreas makes extra insulin to make up for it. For a while, this will work and your blood sugar levels will stay normal.

 

Over time, though, your pancreas won’t be able to keep up. If you don’t make changes in the way you eat and exercise, your blood sugar levels will rise until you have prediabetes.

Will look for these blood test results:

 

Fasting plasma glucose test: 100-125

Oral glucose tolerance test: 140-199 after the second test

A1c results of 5.7% to 6.4%

 

If you aren’t able to manage prediabetes, you’ll be diagnosed with type 2 diabetes when your test levels reach:

 

Fasting plasma glucose test: 126 or higher

Oral glucose tolerance test: 200 or higher after the second test

A1c results of 6.5% or above

Insulin Resistance Treatment and Prevention

You can take steps to reverse insulin resistance and prevent type 2 diabetes:

 

Exercise. Go for at least 40 minutes a day of moderate activity (like brisk walking) 5 or more days a week and at 2 days of Muscular Strenuous exercise. If you're are not active ,Start exercise regularly

 

Get to a healthy weight. If you're not sure what you should weigh or how to reach a weight loss goal, ask your doctor. You may also want to talk with a nutritionist.

Eat a healthy diet. Think fruits, vegetables, whole grains, nuts, beans, fish, legumes, and other lean protein.

Take medications. Your doctor may prescribe a medication called metformin  to help keep your blood sugar in check.

 

Complications of Insulin-Resistance

 Severe high blood sugar

Severe low blood sugar

Heart attack

Stroke

Kidney disease

Eye problems

Cancer

Alzheimer’s disease Resistance

If metabolic syndrome goes untreated, it could lead to: Diabetic and Dislipidemia and other complications