Insulin Resistance

Let Your Insulin Work For You

*Insulin Resistance

If you have pre-diabetes or diabetes, chances are that you’ve heard of the medical term insulin resistance syndrome or metabolic syndrome. Insulin resistance or metabolic syndrome describes a combination of health problems that have a common link — an increased risk of early heart disease. The cluster of medical conditions that make up the insulin resistance syndrome or metabolic syndrome places a person at risk of developing type 2 diabetes and atherosclerosis (hardening of the arteries). It is estimated that 70 to 80 million Americans have the combination of diseases caused by insulin resistance or metabolic syndrome.

Diseases caused by insulin resistance include the following:

  • Obesity
  • Type 2 diabetes
  • High blood pressure
  • Abnormal cholesterol levels
  • Heart disease
  • Polycystic Ovarian Syndrome (PCOS)

What Is Insulin Resistance?

Normally, food is absorbed into the bloodstream in the form of sugars such as glucose and other basic substances. The increase in sugar in the bloodstream signals the pancreas (an organ located behind the stomach) to increase the secretion of a hormone called insulin. This hormone attaches to cells, removing sugar from the bloodstream so that it can be used for energy.

In insulin resistance, the body’s cells have a diminished ability to respond to the action of the insulin hormone. To compensate for the insulin resistance, the pancreas secretes more insulin.

People with this syndrome have insulin resistance and high levels of insulin in the blood as a marker of the disease rather than a cause. Over time people with insulin resistance can develop high sugars or diabetes as the high insulin levels can no longer compensate for elevated sugars.

What Are The Health Components of Insulin Resistance Syndrome?

The health components of insulin resistance syndrome include:

  • Impaired fasting blood sugar, impaired glucose tolerance or type 2 diabetes. This occurs because the pancreas is unable to turn out enough insulin to overcome the insulin resistance. Blood sugar levels rise and diabetes is diagnosed.
  • High blood pressure. The mechanism is unclear, but studies suggest that the worse the blood pressure, the worse the insulin resistance.
  • Abnormal cholesterol levels. The typical cholesterol levels of a person with insulin resistance are low HDL, or good cholesterol, and high levels of another blood fat called triglycerides.
  • Heart disease. The insulin resistance syndrome can result in atherosclerosis (hardening of the arteries) and an increased risk of blood clots.
  • Obesity. A major factor in the development of insulin resistance syndrome is obesity — especially abdominal obesity or belly fat. Obesity promotes insulin resistance and negatively impacts insulin responsiveness in a person. Weight loss can improve the body’s ability to recognize and use insulin appropriately.
  • Kidney damage. Protein in the urine is a sign that kidney damage has occurred, although not everyone uses this component to define insulin resistant syndrome. Insulin Resistance and Diabetes

How Is Insulin Resistance Syndrome Diagnosed?

There is no simple test to diagnose insulin resistance syndrome. Rather, your doctor may suspect the syndrome if you have the following health risk factors:

  • More than one parent or sibling who has type 2 diabetes, high blood pressure, or cardiovascular disease.
  • Obesity or overweight (BMI — body mass index — above 25).
  • More fat around the waist than around the hips (an apple shape).
  • Age greater than 40 years
  • Gestational diabetes when pregnant.
  • A history of a condition called polycystic ovarian syndrome (PCOS).
  • Pre-diabetes.
  • Are a member of certain ethnic groups (Latino, Blacks, or Native American).

The current epidemic of obesity in children also puts them at risk for the development of the insulin resistance syndrome.

What’s The Treatment for Insulin Resistance Syndrome?

Specific prescribed medications such as Glucophage (metformin), Actos (pioglitazone) and Avandia (rosiglitazone) are all approved to treat the insulin resistance that occurs with type 2 diabetes. These drugs make your body more sensitive to the actions of insulin. Multiple drugs, such as cholesterol-lowering drugs or anti-hypertensive drugs are usually necessary to treat the different conditions that are part of the insulin resistance syndrome.

Is Insulin Resistance Syndrome Preventable?

Yes. If you live a healthy lifestyle, you may be able to avoid getting insulin resistance syndrome and the associated diseases. Here are some tips to prevent insulin resistance or metabolic syndrome:

  • Exercise. Try walking 30 minutes a day for at least 5 days a week (exercise can be divided into 3 separate periods of 10 minutes each)
  • Stay at a healthy weight
  • Eat right. A healthy balanced and caloric restricted diet is recommended. Reviewed by Certified Diabetes Educators in the Department of Patient Education and Health Information and by physicians in the Department of Endocrinology at The Cleveland Clinic.