Insulin is a hormone made by the pancreas that works in the body to help regulate blood sugar, control metabolism, and regulate cellular growth.
Insulin resistance occurs when the body's cells become resistant to the effects of insulin. The result is that the body needs higher levels of insulin to function properly.
The pancreas tries to offset this need by producing more insulin until it can no longer produce what the body needs and blood sugar levels rise. This increases the risk for diabetes and heart disease.
There are some rare types of insulin resistance:
- Type A insulin resistance syndrome
- Causes the body to not process blood sugar well
- Insulin is unable to be used normally by the body’s cells
- Causes other problems such as skin changes and ovarian cysts
- Can also lead to diabetes
- Type B insulin-resistance syndrome
- Belongs to the group of extreme insulin-resistance syndromes (which includes leprechaunism, the lipodystrophies, Rabson-Mendenhall syndrome, and type A insulin resistance syndrome; see these terms)
- Occurs in the context of immune dysfunction
- Affects middle-aged adults, predominantly females
- Often begins with rapidly progressive nonketotic and severely insulin-resistant diabetes, along with acanthosis nigricans (typical skin lesion associated with insulin resistance) and hirsutism
- Paradoxical low blood sugar (hypoglycemia) may occur and can be severe
What Are Symptoms of Insulin Resistance?
Insulin resistance often causes no symptoms.
Signs of high blood sugar (hyperglycemia) that may indicate possible insulin resistance include:
Symptoms of type A insulin resistance syndrome in women may include:
- Dark, thick, and velvety skin in body folds (acanthosis nigricans)
- Excess hair on face, chest, and back
- Acne
- Light and irregular periods
- No periods
- Cysts and increased scar tissue on the ovaries
- Fertility problems
- High levels of testosterone
- Low blood sugar after eating
Men have fewer symptoms of type A insulin resistance syndrome, such as:
- Acanthosis nigricans
- Low blood sugar after eating
- Adult-onset diabetes
Symptoms of type B insulin resistance syndrome include:
- Abnormal circulating fatty-acid concentration
- Abnormal oral glucose tolerance
- Acanthosis nigricans
- Elevated erythrocyte sedimentation rate (ESR)
- High blood insulin levels while fasting
What Causes Insulin Resistance?
Obesity, especially excess fat in the abdomen and around the organs (visceral fat), is a main cause of insulin resistance.
A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance.
Physical inactivity is another main cause of insulin resistance.
Other causes of insulin resistance include:
- Metabolic syndrome
- Excess weight (particularly around the waist)
- High blood pressure
- High cholesterol and triglycerides
- Genetic factors
- Steroid use
- Older age
- Smoking
- Certain medications
- Pregnancy
- Infection or severe illness
- Stress
- Sleep problems, such as sleep apnea
Risk factors for developing insulin resistance include:
- Age over 40 years
- Ethnicity: Latino, African American, Native American, or Asian American
- A history of high blood pressure, high blood triglycerides, low HDL cholesterol, arteriosclerosis (or other components of the metabolic syndrome)
- Having close family members with type 2 diabetes, high blood pressure, or arteriosclerosis
- Past gestational diabetes
- Polycystic ovarian syndrome (PCOS)
- Acanthosis nigricans
Type A insulin resistance syndrome is caused by a change (mutation) in one or more genes that causes cells to not use insulin normally.
Type B insulin resistance syndrome is caused by autoantibodies to the insulin receptor.
What Is the Treatment for Insulin Resistance?
Insulin resistance is treated with lifestyle changes and medications.
Lifestyle changes to treat insulin resistance include:
- Diet
- Low glycemic index foods
- Weight loss
- Regular exercise
- Stress reduction
- Getting adequate sleep
Medications used to treat insulin resistance include:
- Metformin (Glucophage)
- Acarbose (Precose)
- Thiazolidinediones such as pioglitazone (Actos) and rosiglitazone (Avandia)
Treatment of type A insulin resistance involves the above modalities.
Treatment of type B insulin resistance also includes addressing any underlying autoimmune disorder.
Health Solutions From Our Sponsors
https://www.cdc.gov/diabetes/basics/insulin-resistance.html
https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
https://emedicine.medscape.com/article/122501-treatment
https://www.aarda.org/insulin-resistance-signs-symptoms/
https://rarediseases.info.nih.gov/diseases/3009/insulin-resistance-type-b