Insulin resistance means a decreased sensitivity of the body to the action of insulin - a hormone responsible mainly for the regulation of blood sugar levels, but also fat management. Insulin resistance is very dangerous as it can lead to the development of type 2 diabetes or other diseases. This is especially true for people who are overweight and obese, who are at the highest risk of developing insulin resistance. Insulin resistance may also occur in lean people with other diseases, such as the liver. What are the causes and symptoms of insulin resistance? Is it possible to cure her?

Insulin resistanceis a state of reduced body sensitivity toinsulin , the consequence of which is a number of metabolic disorders, i.e. excessive glucose production by the liver, weakening of sugar uptake by peripheral tissues, e.g. skeletal muscles or disturbance of fat metabolism (increase of circulating free fatty acids). The decline in insulin sensitivity is compensated for by increasing insulin production, i.e. hyperinsulinemia. In the initial stage of insulin resistance, the amount of hormone produced is sufficient to cover the body's needs. However, with the duration of the disorder, a self-reinforcing loop develops, where hyperinsulinemia increases insulin resistance and insulin resistance - hyperinsulinemia. When the regulatory mechanisms are exhausted, carbohydrate disorders and the development of pre-diabetes, type 2 diabetes and cardiovascular diseases are revealed.

Insulin resistance is not a separate disease, butis part of the so-called metabolic syndrome , which are groups of disorders that often occur together in one person and are closely related. These are obesity, arterial hypertension (research shows that in all obese patients with arterial hypertension and in 40% of lean patients with essential hypertension with normal glucose levels, elevated blood insulin levels are found), disturbances in triglyceride and cholesterol metabolism, and glucose levels fasting blood equal to or greater than 100 mg / dL.

Insulin resistance: causes and risk factors

Insulin resistance may have genetic background , e.g. when the body produces a hormone with an abnormal structure (the so-calledmutant insulin syndrome ).

Reduction in insulin sensitivity occurs in many diseases, such as :

  • hyperthyroidism
  • hypothyroidism
  • overactive adrenal cortex
  • acromegaly
  • pheochromocytoma
  • cancer
  • inflammation - acute and chronic
  • liver diseases e.g. cirrhosis
  • hemochromatosis
  • advanced kidney failure
  • chronic heart failure
  • hypertension

The riskof developing insulin resistance occurs in people struggling withoverweight and obesity , because adipose tissue makes their bodies the most insulin resistant.

Adipose tissue , mainly abdominal, contributes to insulin resistance by producing hormonal substances that oppose or inhibit insulin, and by direct secretion into the blood the so-called free fatty acids (PUFA).

In excess, the body begins to use them as an energy source instead of glucose. As a consequence, glucose is not burned in the tissues and its level in the blood rises. Then the body, in order to maintain the proper level of sugar in the blood, increases the secretion of insulin.

Other risk factors are:

  • age (the risk of developing the disease increases with age) - insulin resistance is a natural process of the aging organism, so you should be aware that with age, the impairment of tissue sensitivity to insulin increases.
  • gender (men are more likely to be diagnosed with abdominal obesity, which is a high risk factor for developing insulin sensitivity impairment)
  • low physical activity
  • high-calorie diet
  • use of diabetogenic drugs (glucocorticosteroids, thiazide diuretics, HIV protease inhibitors, birth control pills, loop diuretics, calcium channel blockers)
  • alcohol
  • smoking
  • pregnancy

Insulin resistance: what diseases can it lead to?

  • diseases of the cardiovascular system- mainly atherosclerosis
  • nonalcoholic fatty liver disease- both insulin resistance increases the incidence of nonalcoholic fatty liver disease and this disease increases tissue resistance to insulin
  • polycystic ovary syndrome- some people suspectthat excess insulin can stimulate certain ovarian cells to produce male sex hormones; they may contribute to the development of polycystic ovary syndrome in women with a genetic predisposition to this disorder
  • type 2 diabetes- because maintaining insulin at an abnormally high level over and overloads the pancreas. As a consequence, over time, her efficiency decreases, and thus - the amount of insulin secreted decreases, which sooner or later leads to the appearance of diabetes symptoms.
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Author: Time S.A

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Insulin resistance: symptoms

Insulin resistance can take place in a latent manner or manifest itself in various ways, e.g. through:

  • carbohydrate disorders
  • increase in blood cholesterol level
  • increase in blood triglyceride concentration above the norm
  • android type obesity
  • hypertension
  • blood uric acid increased

Insulin resistance: diagnosis

Isulin resistance can be diagnosed in several ways:

  • Oral Glucose Load Test

The test consists in administering glucose to the patient and observing his body's reaction to it: insulin secretion, speed of blood sugar regulation, speed of glucose absorption into tissues.

  • HOMA (Homeostatic Model Assessment) method

Fasting blood is collected from the patient and the concentration of glucose and insulin is determined. Then, on this basis, using the appropriate formula, the so-called insulin resistance index (HOMA-IR).

  • metabolic clamp method - determining the GIR parameter, i.e. the glucose infusion rate - is only used in clinical trials

The metabolic clamp method is based on the simultaneous administration of glucose and insulin in a drip to the patient - the amount of insulin remains the same and the amount of glucose is modified. This method is the best as it has a proveneffectiveness in determining the real degree of insulin resistance , in contrast to the HOMA method, which can produce inconclusive results in some situations. Unfortunately, because of the complexitythe course and high costs of the test are rarely performed.

Insulin resistance: treatment

To lower insulin levels, overweight people need to lose weight as soon as possible .

If your medications cause insulin resistance, your doctor will decide whether to switch to other medications.

If your insulin sensitivity is caused by an excess of hormones that oppose insulin, you should receive treatment to lower them.

Read also:

  • Insulin analogues improve the quality of life of patients with diabetes
  • Pregnancy planning and diabetes. Guiding a diabetic patient during preparation and during pregnancy

Category:

Diabetes