The silent warning sign of diabetes: Learn about insulin resistance

Are you a little scared of the word diabetes? Or have you ever been told by your doctor that you have insulin resistance, and you're confused about what it is? Don't worry. Today, we'll talk about this condition called insulin resistance in a very simple and friendly way. It's like a silent warning that our body gives us before diabetes sets in.

Simply put, what is insulin resistance?

Think about it, the cells in our body are like little houses. These houses need energy to work. That energy comes from the sugar called glucose, which is made from the food we eat. In order for this glucose to go from the blood into the houses called cells, it needs a key to open the door. That key is the hormone called insulin . This insulin key is made by our pancreas.

When you eat, glucose enters the blood. At the same time, the pancreas releases a key called insulin into the blood. When insulin opens the doors of the cells, glucose enters the cells and becomes energy.

Now look at what happens to someone with insulin resistance.

Your cells don't respond properly to this insulin key. It's like a rusty door lock. The key won't open the door properly. So glucose, which can't get into the cells, starts to accumulate in the blood.

At this point, the brain thinks, "Oh, there's a lot of sugar in the blood, I need more keys." So the pancreas gets a message telling it to make more insulin. Over time, the pancreas gets tired, makes more insulin, and eventually its function can decrease. That's when the blood sugar level starts to rise.

The difference between insulin resistance, pre-diabetes, and diabetes

Although these three are related, they are not the same. Let's look at it from a table.

What are the symptoms of this condition?

The biggest problem here is that insulin resistance is a silent condition . You can have it in your body for years without even knowing it. The only way to know for sure is to get a blood test.

However, there are some external signs and symptoms that are associated with this condition. Check to see if you have these too:

• Increased waist circumference: A waist circumference of more than 40 inches in men and more than 35 inches in women.
• High blood pressure: Blood pressure of 130/80 mmHg or higher.
• Abnormalities in blood tests:
• Fasting blood sugar level greater than 100 mg/dL.
• Fasting triglyceride levels greater than 150 mg/dL.
• Good cholesterol (HDL cholesterol) levels less than 40 mg/dL in men and less than 50 mg/dL in women.
• Skin changes:
• The skin on the neck and armpits becomes dark and velvety. This is medically known as Acanthosis Nigricans .
• The appearance of small moles (skin tags) that seem to hang from the skin.

What are the causes of insulin resistance?

It's hard to pinpoint a single cause for this, but experts have identified several factors that increase the risk.

• Excess body weight: Fat accumulation, especially in the abdominal area (belly fat).
• Lack of exercise and sedentary lifestyle: Not being physically active.
• Foods high in carbohydrates: Excessive consumption of bread, rice, sweet foods, and sweetened beverages.
• Family history: Someone in the family has diabetes.
• Age: The risk increases after the age of 45.
• Gestational Diabetes: Mothers who develop diabetes during pregnancy are at increased risk of developing this condition later.
• Other conditions: Nonalcoholic fatty liver disease and Polycystic Ovary Syndrome (PCOS).
• Smoking.
• Certain medications: Long-term use of certain medications, such as steroids.
• Sleep problems: Conditions such as suffocation during sleep (sleep apnea).

The relationship between insulin resistance and PCOS

There is a strong link between polycystic ovary syndrome (PCOS), a condition that affects many women, and insulin resistance. Many women with PCOS also have insulin resistance. The exact link between the two is still being researched.

How do you find this, Doctor?

There is no single test specifically for insulin resistance. Your doctor will look at a combination of factors to diagnose the condition.

1. Questioning you: Asking about your family's health history and your lifestyle.

2. Physical examination: Your weight, height, BMI will be measured. Your blood pressure will be measured.

3. Blood tests: These are the most important.

• Fasting Plasma Glucose (FPG): A blood test done after fasting for at least 8 hours.
• Oral Glucose Tolerance Test (OGTT): First, fasting blood is taken, then a sugary liquid is given to drink, and the blood is tested again two hours later.
• Hemoglobin A1c (HbA1c): This gives an idea of ​​your average blood sugar levels over the past 2-3 months.
• Lipid Panel: Checks cholesterol and triglyceride levels in the blood.

The following values ​​can help you identify whether you have prediabetes :

• FPG: 100-125 mg/dL
• OGTT (after 2 hours): 140-199 mg/dL
• A1c: 5.7% - 6.4%

How do we control this situation?

The good news is that insulin resistance can often be reversed! The key to that is making lifestyle changes. These things are much more powerful than medication.

1. Exercise

When you're active, your muscles need energy. They become more sensitive to insulin and start using the glucose in your blood. Even a simple exercise like brisk walking for 30 minutes a day, at least 5 days a week, can make a big difference.

2. Maintaining a healthy weight

Even losing 5% to 7% of your body weight can significantly reduce your risk of developing diabetes. For example, if you weigh 100 kg, losing 5-7 kg is a big deal. Consult your doctor for advice on this.

3. Changing diet

There is no specific "magic" diet for this, but it is important to be aware of some things.

• High-fiber foods: Foods like whole grains, legumes, vegetables, and fruits increase the feeling of fullness and slow down the rate at which sugar is absorbed into the blood.
• Foods with a low glycemic index (GI): Simply put, these are foods that do not raise blood sugar levels quickly after eating.
• Eat frequently (Low-GI): Lots of vegetables and fruits, brown rice, chickpeas, lentils, yogurt.
• Eat occasionally (Medium-GI): Whole grain bread, bananas, corn.
• Reduce as much as possible (High-GI): white bread, white rice, cakes, biscuits, sweet drinks, potatoes.

4. Other important things

• Avoid smoking.
• Controlling stress.
• Get enough sleep (at least 7 hours a day).

Let's also learn about medication: There is no specific medicine for insulin resistance. However, if you are at very high risk of developing diabetes, your doctor may prescribe a medication like Metformin . But only a doctor can decide.

Insulin Resistance, Diabetes, Prediabetes, Blood Sugar, Blood Sugar, A1C Test Sinhala