Introduction:

                        Insulin is an important hormone that has many actions within the body including those involved in metabolism (control) of carbohydrates (sugars and starches), lipids (fats), and proteins. When insulin resistance develops, tissues in the body – particularly muscle and fat tissues- do not respond appropriately to insulin. In fact, more insulin is needed to elicit the same response from these tissues. As a result, higher levels of insulin are needed in order for insulin to continue to exert its physiologic effect.

Main Content:

            Insulin resistance is a decreased ability of some of the cells of the body to respond to insulin. It is the beginning of the body not dealing well with sugar (and remember that all carbohydrate breaks down into sugar in our bodies).

Causes for Insulin Resistance

There are many causes of insulin resistance, including a strong association with genetics (an inherited component). In addition, insulin resistance is often associated with the following conditions:

• infection or severe illness,
• the metabolic syndrome,
• obesity,
• pregnancy,
• steroid use and with other medications, and
• stress

Diagnosis for insulin resistance:

A firm diagnosis cannot be made simply based on this, since the lab techniques for measuring insulin can vary, and there is no absolute value used for the definition. However, an insulin level above the upper quartile in the fasting state in someone without diabetes is considered abnormal. In addition, an oral glucose tolerance test (OGTT) can be used to detect insulin resistance and is more sensitive for detecting milder/earlier disease. It involves drinking a known amount of simple sugar and measuring blood glucose and insulin levels at baseline as well as one and two (and sometimes three) hours after drinking.

Treatment for insulin resistance:

Weight loss and aerobic exercise (without weight loss) increase the rate at which glucose in the blood is taken up by muscle cells as a result of improved sensitivity of the cells to insulin.

                By altering the diet, particularly the carbohydrates in the diet, the body can decrease the amount of insulin released by the pancreas. Carbohydrates are absorbed into the body after they are broken up into their component sugars. Some carbohydrates are broken up and absorbed faster than others and are referred to as having a high glycemic index. These carbohydrates increase the blood glucose level more rapidly and require the secretion of more insulin to control the level of glucose in the blood.

                Medications have been shown to delay the progression of insulin resistance to overt type 2 diabetes. To date, no study has shown the ability to prevent metabolic syndrome in a high-risk population.

Insulin Resistance Prognosis

It is only in recent years that insulin resistance has been gaining importance both its own right and as a contributor to the metabolic syndrome. It now appears that intervention can delay the onset of overt diabetes. With lifestyle modification and medication if needed, those with insulin resistance can have some control over their disease progression.

For more related information, please refer open access journals.