Learn about Insulin Resistance and Prediabetes

What causes Diabetes, the disease that afflicts millions over the world. We look at some basic facets of Insulin resistance with Nayati Healthcare’s Dr.Jyoti Goyal, HOD, Internal Medicine at Nayati Medicity.

One of the most widespread disease in the world with no alternative but to manage it. With an increasing number of people suffering from it, Diabetes has become a pandemic globally. That said, diabetes has been on the rise in India, with over 69.2 million people living with it in 2015 and presents a grim outlook in the future. 

Even with this magnitude, Diabetes is largely ignored until its diagnosis – with people often blaming genetic factors for its development.

And while genetic predisposition to diabetes certainly decides whether or not you will be diabetic, a sedentary lifestyle and Insulin resistance almost guarantees Type-2 diabetes diagnosis – particularly with modern day diet and habits. 

To understand more on insulin resistance and its implications on diabetes, we sat with Dr Jyoti Goyal of Nayati Medicity, Mathura and to know ways, to understand its signs and manage it.

So, what is Insulin resistance?

It is defined as subnormal biological response to normal insulin concentration and not just the subnormal glucose response. Mostly insulin resistance is associated with obesity but there are many other causes like stress, medications like steroids, pregnancy and rare genetic syndromes causing defects in insulin signalling pathways.

For a layman, Insulin resistance is when cells in your muscles, fat, and liver don’t respond well to insulin and can’t easily take up glucose from your blood.

As a result, your pancreas produces more insulin to help glucose enter your cells. As long as your pancreas can make enough insulin to overcome your cells’ weak response to insulin, your blood glucose levels will stay in the healthy range.

Here’s what a simple Insulin resistance cycle looks like – 

What is Prediabetes?

Prediabetes means your blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. Prediabetes usually occurs in people who already have some insulin resistance or whose beta cells in the pancreas aren’t making enough insulin to keep blood glucose in the normal range. Without enough insulin, extra glucose stays in your bloodstream rather than entering your cells. Over time, you could develop type 2 diabetes.

“We at Nayati Medicity have been seeing an increase in patients with Insulin resistance and a larger number of patients suffering from Type-2 diabetes. That is a worrying trend”, added Dr. Goyal.

Who is at RISK?

Like most diseases, Insulin resistance is rooted in genetics or built with lifestyle habits. Certain risk factors include:

Causes of IR 

  • Overweight or Obesity
  • Stress
  • Medications like steroids, oral contraceptives etc
  • Old age – 45 and above
  • Genetic predisposition – a family history of Insulin resistance
  • African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American ethnicity
  • Physical inactivity and a general sedentary lifestyle

Consequences of IR 

  • High blood pressure and Abnormal cholesterol levels
  • heart disease or stroke
  • Polycystic Ovary Syndrome
  • Metabolic syndrome
  • Obesity related cancers

Obesity related insulin resistance can present in a variety of ways. Initially many patients develop prediabetes and if not controlled in time can develop overt diabetes. Patients already having diabetes may develop increase requirements of insulin to control sugars. Patients having insulin resistance are prone for development of hypertension, heart diseases, and abnormality in lipid profile and occurrence of all these things together is also known as metabolic syndrome. 

Insulin Resistance in females can cause abnormality in their reproductive health characterized by high androgen levels (male hormones) in their body causing infertility, decrease menses and excessive hair growth on their face and cysts in the ovaries. 

Insulin Resistance is also reflected as a skin lesion known as acanthosis nigricans, most commonly found at the nape of the neck, groin, and axilla and over the elbows.

Is there a way to prevent Insulin resistance?

The most common way to prevent insulin resistance is an active lifestyle coupled with a healthy diet. If you’re overweight, you must consider losing weight so that your body can increase its sensitivity to Insulin naturally. Here are a few ways you can increase your insulin sensitivity – 

  1. Exercising more
  2. Working on stress management
  3. Losing  weight
  4. Eating healthy vegetables and fruits
  5. Cutting down on bad carbs

How to diagnose IR 

There is no readily available test to diagnose IR, though fasting insulin levels, glucose to insulin ratio, ratio of triglyceride to HDL And homeostasis model for assessment of insulin resistance are being used in some special clinical settings under the guidance of expert clinicians

Patients having insulin resistance have high insulin levels and higher insulin like growth factors in their blood and this is responsible for all the problems associated with IR.

How to treat Insulin Resistance

Before treating IR it is important to identify individuals who are at high risk of development of IR, so as to prevent all the complications associated with it, in timely fashion. Also  to guide them timely for aggressive life style modification therapy in terms of their diet and physical activity helping them in losing weight and quitting smoking. IR cannot be treated with medications and medicines are used to treat conditions associated with IR, like DM, HTN, Deranged lipids or heart disease etc.

The vital advice is for all those coming in risk category should get their regular preventive health check-ups done routinely available in hospitals.

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