Insulin resistance is a growing concern across the globe as it can be one of the key factors that may lead to diabetes, heart disease and strokes. It affects about 3 out of 100 Americans. Worldwide as many as 25% of adults have metabolic syndrome in which insulin resistance is a component thereby leading to elevated blood glucose levels. It is also becoming a concern among children where insulin resistance along with obesity is on the rise.
What happens in insulin resistance?
The pancreas secretes the hormone, insulin, directly into the bloodstream. This hormone helps to lower blood sugar (glucose) levels. It does this mainly by stimulating the liver to stop glucose production by processing complex nutrients and converts glucose into glycogen. Insulin also stimulates cells to take up more glucose from the bloodstream. Another hormone known as glucagon does the opposite to raise the blood glucose levels when necessary.
In insulin resistance the cells become less responsive to insulin. In other words insulin does not work as effectively as it should. Less glucose is taken up by the cells from the bloodstream and the liver does not slow down or stop its glucose production. As a result, normal amounts of insulin cannot reduce the blood glucose levels and the pancreas secretes even more insulin to achieve the same effect. Insulin resistance is the main reason for type 2 diabetes in contrast to type 1 diabetes where there is a deficiency of insulin.
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How to spot insulin resistance?
The problem in insulin resistance is that a person may be asymptomatic for long periods of time, even years. Testing the blood glucose levels may reveal a moderately elevation until type 2 diabetes sets in an the glucose levels clib higher. However, insulin resistance can also contribute to hypoglycemia (low blood glucose levels). Another test involves testing the levels of insulin in the blood in the morning, before breakfast (fasting insulin).
Being overweight or obese and physically inactive are the main causes of insulin resistance. These are two common problems in modern society and accounts for the rise in insulin resistance within developed nations. While adults are more likely to be affected, children may also be prone. Other causative factors of insulin resistance include advancing age, using certain drugs like steroids, smoking, sleep problems and the presence of certain diseases.
Without routine testing of the blood glucose levels and insulin levels, a person may not know that they have insulin resistance. It is only once the symptoms of diabetes develops that the underlying problem is highlighted. Therefore any person with one or more risk factors should undergo routine testing. Early intervention can reverse insulin resistance and prediabetes before diabetes sets in.
Please note that the signs and symptoms discussed below are for diabetes which eventually arises with prolonged and untreated insulin resistance.
Read more on type 2 diabetes.
A common sign of diabetes is increased thirst, medically referred to as polydipsia. This may not be seen in the early stages of insulin resistance until prediabetes (impaired glucose tolerance) and diabetes sets in.. It develops gradually and many people may initially miss this signs. Sometimes the increased thirst may be mistaken for dryness of the mouth requiring increased water consumption.
Another common sign of diabetes is frequent urination. It is a result of the kidneys overworking due to the elevated blood glucose levels which draws water out of the cells. The increased water consumption also plays a role. In the course of the day, a person passes out a large volume of urine by repatedly urinating. This is known as polyuria. It may be severe enough for a person to awake at night to urinate (nocturia) which disturbs normal sleep patterns.
Increased Hunger with Weight Loss
Increased hunger is another sign of diabetes. The glucose that cannot enter the cells means that the cells are not getting sufficient nutrition and this elicits the sense of hunger. One of the consequences however is that there is unintentional weight loss as glucose is constanly flushed out of the body through urine. Sometimes the increased hunger and weight loss is not major and may pass unnoticed.
Fatigue is another common sign in diabetes. It occurs for several different reasons. Firstly the cells cannot uptake sufficient glucose for energy production. Then dehydration from frequent urination as well as disturbed sleep due to nighttime urination further contributes to fatigue. Sometimes the fatigue is the first symptom that a person may experience without any of the other symptoms.
How to reverse insulin resistance
The root cause of insulin resistance should be identified and removed where possible, for example the use of steroid medication. However, most cases of insulin resistance are due to obesity which is in turn related to dietary factors and lifestyle. Therefore the following measures can reverse insulin resistance or at least improve insulin sensitivity.
- Lose weight through diet and physical activity. Weight loss should be gradual and done in a sustainable manner. Rapid weight loss can have dangerous health effects and often leads to further weight gain thereafter once the initial weight loss program is stopped or reduced.
- Switch to a low calorie and low glycemic index (GI) diet. It is also advisable to eat more small meals in a day rather than fewer large meals. Never exceed the maximum daily calorie intake for weight loss. Consult with a dietitian for professional advice and assistance with constructing a suitable eating plan.
- Become physically active. The target should be at least 150 minutes of exercise per week but this should only be done after approval by a medical doctor. Start off slowly and gradually increase the time until the target is reached.
- Quit smoking. Apart from its role in insulin resistance, tobacco smoking has a host of adverse health effects. Smoking cessation may require a combination of aids such as nicotine replacement products, medication and counselling.
- Reduce alcohol consumption to the recommended daily intake. Adult males should not exceed 3 units of alcohol daily while the limit for women is 2 units daily. Further reduction or even stopping alcohol consumption altogether is always advisable.