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An Overview of Insulin Resistance in Diabetics

written by: Harry Sylvester • edited by: lrohner • updated: 9/20/2010

What is insulin resistance? It occurs when the body’s cells are not responsive to the effects of insulin. The pancreas works to meet the need for insulin, but the pancreas fails, leading to diabetes. Learn how this condition affects your body along with symptoms, causes, diagnosis, and treatment.

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    What is Insulin Resistance?

    Insulin is a hormone produced by the pancreas that allows sugar in the bloodstream to be absorbed by the cells in the body, providing them with necessary energy. Insulin resistance is a condition where the body is unable to use insulin efficiently, causing a reduced ability for the body’s cells to absorb blood sugar. As blood sugar levels increase in the bloodstream, the pancreas produces even more insulin to try to counteract the rise in blood sugar, resulting in abnormal levels of insulin as well. If left untreated, insulin resistance can lead to diabetes.

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    Symptoms

    Insulin resistance can be present for several years without showing any symptoms. If symptoms develop, they normally manifest in a condition called acanthosis nigricans, or a dark ring around the neck, dark patches on the back of the neck, armpits, knees, elbows, and knuckles.

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    Causes

    The cause of insulin resistance may include a genetic predisposition in addition to lack of exercise and excess weight. Insulin resistance associated with high blood glucose levels is a risk factor for having type 2 diabetes. People who are at risk for developing type 2 diabetes often suffer from other conditions such as high blood pressure, excess weight around the waist and increased levels of triglycerides and cholesterol.

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    Who is Most at Risk?

    There are several risk factors associated with insulin resistance:

    • You are 40 years old or more
    • Your body mass index (BMI) is more than 25
    • You are Hispanic, Native American, African American, or Asian American
    • You have a family history of diabetes or high blood pressure
    • You have high triglycerides, high blood pressure (hypertension), or low good cholesterol (HDL levels)
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    Diagnosis

    Several tests and examinations below can detect insulin resistance including:

    The Homeostatic Model Assessment (HOMA)

    It can measure insulin levels and glucose, then the doctor can calculate to evaluate insulin sensitivity and beta cell function.

    Lipid profile

    This test checks the levels of total cholesterol, triglycerides, HDL (good cholesterol), and LDL (bad cholesterol).

    Glucose

    Tests might involve fasting glucose test and glucose tolerance test. Both tests are important to help determine if you are inclined to develop diabetes.

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    Treatment

    Reducing the need for insulin and boosting the sensitivity of the cells to insulin are critical to treating insulin resistance. This can often be accomplished by:

    A change in diet and regular exercise

    Changing the diet can decrease the need for insulin by limiting consumption of carbohydrates responsible for elevating blood sugar levels. The glycemic index rates carbohydrates by the speed in which the body absorbs them, thereby determining how high they will elevate blood sugar levels. Carbohydrates with a high glycemic index include white bread and cornflakes, which can be also dangerous to your heart. It is recommended that you switch to carbohydrates rated low on the glycemic index like fruits, vegetables, high-fiber cereal, whole grains, legumes and nuts.

    Adding regular physical activity to your daily routine can boost the sensitivity of the cells to insulin. You should plan on a minimum of 30 minutes per day of some type of physical activity or exercise.

    Medications

    Medications taken to treat diabetes include metformin (Glucophage) and acarbose (Precose). Both medicines can help decrease the body's need for insulin.

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    References

    Medicinenet.com: Insulin Resistance - http://www.medicinenet.com/insulin_resistance/article.htm

    The National Diabetes Information Clearinghouse: Insulin Resistance and Pre-Diabetes - http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/

    The American Heart Association: Metabolic Syndrome - http://www.americanheart.org/presenter.jhtml?identifier=4756