Is your body not responding properly to insulin? (Insulin Resistance) Let's learn about it simply!

Today we are going to talk about a word that is talked about by many people, and it is also a bit scary. That is 'Insulin Resistance'. Maybe your doctor has told you about it, or you have read about it somewhere. What is it really? Why is it so important? Let's understand all this simply.

So, what is 'Insulin Resistance'?

Simply put, insulin resistance is when the cells in your body, especially those in your muscles, fat cells, and liver, don't respond properly to the hormone insulin. This is also called impaired insulin sensitivity.

Think about it, insulin is an essential part of our body. It's like a traffic controller in our body. It's what helps us send glucose, or the sugar we eat from our blood, into our cells to make energy. Now, what happens when cells don't listen to this insulin properly? The sugar in the blood can't get into the cells and accumulates in the blood.

What happens then? What happens to the pancreas?

That's when the problem starts. Our pancreas – our body's insulin factory – realizes, "Oh, the blood sugar is getting too high, and it's not getting into the cells." So what does the pancreas do? It starts making more and more insulin to control the high sugar levels. It's like pushing a door open when it can't open. We call this hyperinsulinemia.

For a while, if the pancreas can produce more insulin in this way and control blood sugar levels, there is no big problem. But, gradually, as the cells become more resistant to insulin, no matter how much insulin the pancreas produces, it is not enough. That is when blood sugar levels start to be constantly high. We call this 'hyperglycemia'.

Is this 'insulin resistance' dangerous? What are the possible consequences?

Yes, if you keep this up, it can be a little dangerous. Because, when these elevated blood sugar levels persist for a long time, you can develop 'prediabetes'. That means you're on the verge of developing diabetes. And then, you're much more likely to develop Type 2 diabetes.

Not only that, this condition is associated with several other health problems:

• Obesity , especially excess fat in the abdominal area.
• Cardiovascular disease , which means heart disease and blood vessel problems.
• Metabolic dysfunction-associated steatotic liver disease , formerly known as non-alcoholic fatty liver disease.
• Metabolic syndrome. This is not a single disease, but a group of symptoms that come together. For example, high blood pressure, high blood sugar, increased belly fat, and cholesterol imbalances.
• Polycystic Ovary Syndrome (PCOS). This is a hormonal imbalance that occurs in women.

Who is more likely to develop 'insulin resistance'?

It can actually happen to anyone. You don't have to have diabetes. Sometimes it can be temporary. For example, if you take steroids for a while for an illness, you can develop insulin resistance. It can also be chronic, meaning it's a long-term condition.

There are two main factors that are thought to influence this:

1. Excess body fat , especially around your belly.

2. Lack of physical activity , which means not exercising.

Also, if someone in your family has diabetes (especially type 2 diabetes), prediabetes, or conditions like polycystic ovary syndrome (PCOS), you may also be more prone to developing insulin resistance.

Insulin resistance is common in people with prediabetes and type 2 diabetes. People with type 1 diabetes can also sometimes develop insulin resistance.

What are the symptoms of this? How do we know?

Here's the problem. Most of the time, if your pancreas can make more insulin and control your blood sugar levels, you may not have any symptoms. You may not even know it.

However, over time, this condition can become progressively worse. The cells in the pancreas that make insulin also gradually begin to weaken. Eventually, the pancreas is unable to produce enough insulin. That's when blood sugar levels start to rise and symptoms begin to appear.

When your blood sugar levels remain high, you may experience symptoms like:

• Weight loss for no reason
• Feeling tired all the time
• Feeling more thirsty than usual
• Frequent urination
• Feeling more hungry than usual
• Blurred vision
• Frequent yeast infections (especially in the vagina and sometimes in skin folds in women)

Many people with prediabetes don't have any symptoms, sometimes for years. Prediabetes may not show any symptoms until it progresses to type 2 diabetes. However, some people with prediabetes may show symptoms such as:

• Darkening of your armpits, the back of your neck, and the sides of your body . This is called acanthosis nigricans . It looks like dirt, but it's not dirt.
• Small skin lumps .
• Changes in the eyes . These can lead to diabetes-related eye damage (diabetes-related retinopathy).

Important: If you have one or more of these symptoms, be sure to see your doctor. It's very important.

Why do we develop 'insulin resistance'? What are the causes?

Scientists are still working to figure out exactly how this happens. It is currently known that certain genes can make a person more or less likely to develop insulin resistance. Doctors also know that the condition worsens with weight gain, and that losing weight can help control it to some extent.

Apart from that, there are several other reasons.

Acquired causes

These are not the reasons we are born with, but the reasons that arise during our lifetime.

• Excess body fat: Scientists believe that obesity is the main cause of insulin resistance. Fat deposited in the abdominal area and around internal organs (visceral fat) greatly increases the risk.
• Physical inactivity: When you exercise, your body becomes more sensitive to insulin. Exercise also helps your muscles absorb glucose from your blood, which can lead to this condition.
• Diet: Eating highly processed foods, foods high in carbohydrates, and foods high in saturated fats have been found to be associated with insulin resistance.
• Some medications: Some medications, such as steroids, some medications for high blood pressure, and medications used to treat HIV, can also cause insulin resistance.

Hormonal disorders that cause insulin resistance

Some hormonal problems can also affect the way the body uses insulin.

• Cushing's syndrome: This is a rare condition. It occurs when there is too much of a hormone called cortisol in the body. Excess cortisol interferes with the function of insulin.
• Acromegaly: This is also a very rare but serious condition. It occurs when there is too much growth hormone (GH) in the body. This can also lead to insulin resistance.
• Hypothyroidism: This means that your thyroid gland is not working properly, meaning it is not producing enough thyroid hormones. This slows down your metabolism, which can also cause insulin resistance.

Genetic conditions that cause insulin resistance

There are some genetic diseases that are inherited and can also cause insulin resistance. These are very rare. Examples include conditions called Type A insulin resistance syndrome and Donohue syndrome.

And several other genetic conditions:

• Myotonic dystrophy: This is a type of muscle weakness that affects the muscles, eyes, and organs of the endocrine system.
• Alström syndrome: This condition causes obesity and type 2 diabetes. It can also cause vision and hearing loss, dilated cardiomyopathy, and shortness of breath.
• Werner syndrome: This causes rapid aging (progeria). It affects many things in the body, including insulin resistance.
• Inherited lipodystrophy: In this condition, your body doesn't use or store fat properly.

How do doctors diagnose this?

Insulin resistance is a bit tricky to diagnose precisely, as there is no specific, universal test for it. As mentioned earlier, if your pancreas can produce enough insulin to control the condition, you won't have any symptoms.

However, when your doctor suspects this condition, they will consider several factors:

• Your medical history (such as previous illnesses and medications you take)
• Your family health history (does anyone in your family have diabetes or heart disease?)
• Physical examination
• The symptoms you describe

What tests are being done for this?

The doctor may do several blood tests, such as:

• Glucose test: A fasting plasma glucose (FPG) or regular blood sugar test can help determine whether you have prediabetes, type 2 diabetes, or gestational diabetes.
• A1c test: This can tell you what your blood sugar levels have been like over the past three months.
• Lipid panel: This measures the different types of fats (such as cholesterol and triglycerides) in your blood.

So, how do you treat this? (Treatment)

Not all causes of insulin resistance can be treated, such as genetics and age. Therefore, the main treatment is to make lifestyle changes.

These lifestyle changes are:

• Eat a nutritious diet: Your doctor may tell you to cut down on carbohydrates and unhealthy fats. This means cutting back on sugar, red meat, and processed starchy foods. Instead, they may tell you to eat more vegetables, fruits, legumes, and whole grains. For protein, fish and chicken are good options.
• Physical activity: Moderate daily exercise is very helpful. It increases the use of glucose in the blood for energy, and also increases insulin sensitivity in the muscles.
• Losing excess weight: In some cases, losing weight can help reverse insulin resistance. Your doctor can talk to you about ways to help you lose weight.

Over time, these lifestyle changes can lead to results like these:

• Decreased insulin resistance
• Decreased blood sugar levels
• Low blood pressure
• Decreased triglyceride and LDL (bad cholesterol) levels
• Increased HDL (good cholesterol) levels

Your doctor may also refer you to a specialist, such as a nutritionist or endocrinologist. They will work with you to develop a treatment plan that is right for you.

Is there a special medicine for this?

Currently, there is no specific treatment for insulin resistance. However, your doctor may prescribe medication for other health conditions you may have. Some examples include:

• Medicine for high blood pressure
• Medications like Metformin for diabetes or prediabetes
• Medications like statins to lower LDL cholesterol

Can insulin resistance be reversed? (Reversibility)

Since there are many factors that contribute to this, not all causes can be reversed. However, lifestyle changes can make a big difference. Eating a nutritious diet, exercising regularly, and losing excess weight can help reduce your insulin resistance. Talk to your doctor about what you can do to best manage this.

How does diet affect insulin resistance?

The foods you eat have a big impact on your blood sugar and insulin levels. The Glycemic Index (GI) is a measure of how quickly the foods you eat raise your blood sugar levels.

Foods with a high GI usually contain a lot of carbohydrates and/or sugar. When you eat them, your blood sugar levels rise quickly, and you need a lot of insulin to lower them back down. Therefore, you should avoid eating a lot of sugary drinks (soda, soft drinks, artificial fruit drinks) and foods like:

• Bread (white bread)
• Potato
• Types of cereals for breakfast
• Sweet foods like cakes and biscuits
• Some fruits like watermelon and dates (these are high in sugar)

When you eat foods with a low GI , your blood sugar level rises more slowly. This means your pancreas doesn't have to work as hard to produce insulin. It's generally better for people with insulin resistance to eat foods with a low GI, such as:

• Legumes like beans, chickpeas, and lentils
• Fruits like apples and berries
• Low-starch vegetables - examples: asparagus, cauliflower, green leafy vegetables
• Nuts
• Dairy foods, fish, meat

Remember: Always talk to your doctor before making any major changes to your diet. He/she can advise you on the best course of action for you.

What are the risk factors for developing insulin resistance? (Risk Factors)

Certain genetic and lifestyle risk factors can increase your risk of developing insulin resistance or prediabetes. These risk factors include:

• Overweight or obesity , especially excess fat around the belly.
• Age 45 years or older.
• Having diabetes in a close family member (parents, siblings).
• Physical inactivity.
• Having health conditions like high blood pressure and high cholesterol.
• Having diabetes during pregnancy (gestational diabetes).
• Having heart disease or stroke.
• Sleep disorders , for example, sleep apnea.
• Smoking.

Also, the risk may be slightly higher if you belong to these ethnic groups:

• Black
• Hispanic/Latino
• Asian
• Middle Eastern

We can't change some risk factors, such as family history and age. However, you can try to reduce your risk of developing this condition by maintaining a healthy weight that suits you and exercising regularly.

What is the outlook for someone with insulin resistance?

If you have this condition, ask your doctor what you can expect and how to best manage it.

Your outlook depends on several factors:

• The cause of insulin resistance
• The severity of insulin resistance
• How well you and your doctor manage this condition

Some people may have mild insulin resistance, which may never progress to prediabetes or type 2 diabetes. They may also have insulin resistance that can be reversed or managed with lifestyle changes.

What complications can occur due to insulin resistance?

If this condition is not managed properly, complications can occur. Possible complications include:

• Type 2 diabetes
• Metabolic syndrome
• Heart disease

Not everyone with insulin resistance will develop complications. If you have been diagnosed with this condition, it is important to try to prevent these complications. Be sure to see your doctor regularly, and follow your treatment plan carefully.

When should I see a doctor about insulin resistance?

If you have been diagnosed with this condition, it is very important to see your doctor regularly. He/she can check that your blood sugar levels are at a healthy level and that your treatment is working.

If you have symptoms of high blood sugar or prediabetes, see your doctor right away. He/she can do simple tests to check your blood sugar levels.

If someone in your family has diabetes or insulin resistance, talk to your doctor about your risk of developing this condition.

What questions should I ask the doctor?

If you are diagnosed with this condition, it may be helpful to ask your doctor these questions:

• What is the cause of my insulin resistance?
• What is my risk of developing prediabetes or type 2 diabetes?
• Is there any medicine I can take?
• Should I see a specialist for this condition?

Finally, things we need to remember (Take-Home Message)

So, we've seen that insulin resistance is a bit of a complex condition, and it can affect our health in many ways. Often, it doesn't show any symptoms until it turns into prediabetes or type 2 diabetes.

Therefore, the best thing you can do is try to prevent this condition, or at least reverse it if it occurs. To do this , maintain a healthy weight that suits you, exercise regularly, and eat nutritious foods.

However, sometimes it is not possible to prevent or treat all of the factors that contribute to this condition. If you have any questions about your risk or about this condition, be sure to talk to your doctor. They are there to help you.

` Insulin resistance, diabetes, prediabetes, blood sugar, pancreas, obesity, healthy eating, exercise, hormones