Insulin resistance definition and facts

Exercise may help prevent insulin resistance.

 Insulin resistance may be part of the metabolic syndrome, and it has been associated with
higher risk of developing heart disease.
 Insulin resistance precedes the development of type 2 diabetes (T2D).
 The causes of insulin resistance include both genetic (inherited) and lifestyle factors.
 There are no specific signs and symptoms of insulin resistance.
 Insulin resistance is associated with other medical conditions, including
o fatty liver,
o arteriosclerosis,
o acanthosis nigricans,
o skin tags, and
o reproductive abnormalities in women.
 Individuals are more likely to have insulin resistance if they have any of several associated
medical conditions. They also are more likely to be insulin resistant if obese or of Latino, African-
American, Native American, or Asian-American heritage.
 While there are genetic risk factors, insulin resistance can be managed with diet, exercise, and
proper medication.
 The test for insulin resistance is the measurement of fasting blood glucose and insulin levels.
 Insulin resistance is treated by lifestyle modifications and in some cases, medications.
 In some cases insulin resistance cannot be prevented, but modifiable risk factors include
maintaining a healthy weight and getting regular exercise.

What is insulin resistance?

Insulin is a hormone produced by the beta cells of the pancreas. These cells are scattered
throughout the pancreas in small clusters known as the islets of Langerhans. The insulin
produced is released into the blood stream and travels throughout the body. Insulin is an essential
hormone that has many actions within the body. Most actions of insulin are directed at
metabolism (control) of carbohydrates (sugars and starches), lipids (fats), and proteins. Insulin
also regulates the functions of the body's cells, including their growth. Insulin is critical for the
body's use of glucose as energy.

Insulin resistance (IR) is a condition in which the body's cells become resistant to the effects of
insulin. That is, the normal response to a given amount of insulin is reduced. As a result, higher
levels of insulin are needed in order for insulin to have its proper effects, and the pancreas
compensates by trying to produce more insulin. This resistance occurs in response to the body's
own insulin (endogenous) or when insulin is administered by injection (exogenous).

With insulin resistance, the pancreas produces more and more insulin until the pancreas can no
longer produce sufficient insulin for the body's demands, and then blood sugar rises. Insulin
resistance is a risk factor for development of diabetes and heart disease.
Type 2 Diabetes Symptoms and Warning Signs

Because symptoms of type 2 diabetes are sometimes subtle, the major symptom often is being
overweight. Other symptoms of type 2 diabetes include:

 Excess thirst
 Frequent urination
 Weight gain or loss without trying
 Fatigue
 Excessive thirst
 Urine odor
 Dark skin under chin, groin, or armpits

What are the signs and symptoms of insulin resistance?

There are no specific signs and symptoms of insulin resistance.

What causes insulin resistance?

There are several causes for insulin resistance, and genetic factors (inherited component) are
usually significant. Some medications can contribute to insulin resistance. In addition, insulin
resistance is often seen with the following conditions:

 The metabolic syndrome is a group of conditions involving excess weight (particularly around
the waist), high blood pressure, and elevated levels of cholesterol and triglycerides in the blood.
 Obesity
 Pregnancy
 Infection or severe illness
 Stress
 Inactivity and excess weight
 During steroid use

Other causes of or factors that may worsen insulin resistance can include:

 Taking certain medications

 Older age
 Sleep problems (especially sleep apnea)
 Cigarette smoking

What is the relationship between insulin resistance and diabetes?

Type 2 diabetes mellitus (T2D) is the type of diabetes that occurs later in life or with obesity at
any age. Insulin resistance precedes the development of type 2 diabetes, sometimes by years. In
individuals who will ultimately develop type 2 diabetes, research shows that blood glucose and
insulin levels are normal for many years, until at some point in time, insulin resistance develops.
High insulin levels are often associated with central obesity, cholesterol abnormalities, and/or
high blood pressure (hypertension). When these disease processes occur together, it is called the
metabolic syndrome.

One action of insulin is to cause the body's cells (particularly the muscle and fat cells) to remove
and use glucose from the blood. This is one way by which insulin controls the level of glucose in
blood. Insulin has this effect on the cells by binding to insulin receptors on the surface of the
cells. You can think of it as insulin "knocking on the doors" of muscle and fat cells. The cells
hear the knock, open up, and let glucose in to be used. With insulin resistance, the muscles don't
hear the knock (they are resistant). So the pancreas is notified it needs to make more insulin,
which increases the level of insulin in the blood and causes a louder knock.

The resistance of the cells continues to increase over time. As long as the pancreas is able to
produce enough insulin to overcome this resistance, blood glucose levels remain normal. When
the pancreas can no longer produce enough insulin, blood glucose levels begin to rise. Initially,
this happens after meals -- when glucose levels are at their highest and more insulin is needed --
but eventually while fasting too (for example, upon waking in the morning). When blood sugar
rises abnormally above certain levels, type 2 diabetes is present.