Insulin Resistance 101: The Complete Guide to Understanding Causes, Symptoms and Treatments

The story of diabetes and insulin resistance are two sides of the same coin. The underlying cause of type 2 diabetes is insulin resistance.

According to the International 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 know all the necessary information about insulin resistance and diabetes, which we explain in this article.

What is insulin resistance?

Insulin resistance is when 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. 

What is the Difference Between Insulin Resistance and Diabetes?

A common question is: Does insulin resistance cause diabetes, or does insulin resistance mean diabetes?

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

Lifestyle modifications can prevent prediabetes, 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 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 releases 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 glucose to return to the liver.

In the liver, excess glucose results in increased lipogenesis, thus causing a rise of circulating fatty acids, leading to fat deposition in the body. Fat deposition typically 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 Risks? 

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

It leads to 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 few signs in the early stage of the condition. It is tough to find it by a physical examination in the beginning. 

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

Dark, velvety patches can be on the neck, armpits, and groin. This condition is known as Acanthosis nigricans,  and it indicates an underlying 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 exist, meet your healthcare provider for further assessment. Elevated blood pressure (over 140/90 mmHg) and high serum triglyceride indicate underlying insulin resistance. 

Prevention and Treatment 

Fortunately, positive lifestyle measures can effectively useful 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 five 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 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 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, your body weight will increase.   

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 underlying 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 prevent and reverse it.

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