What is insulin resistance, how common is it and how is it diagnosed? – Violet
According to the National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) insulin resistance is a condition in which the body produces insulin but does not use it effectively. Insulin is a hormone that helps cells absorb glucose from the blood. Acting like an usher, insulin normally allows blood sugar to enter muscle, liver and fat cells. Over time the insulin has less of an effect. When the cells are resistant, it takes more and more insulin to do the same job. This problem is three-fold. First, the pancreas works overtime to produce insulin, eventually failing to keep up with demand. Second, when this happens more sugar is left in the blood [elevated blood sugar is observed]. Third, the higher level of insulin surging around prevents fat cells from releasing fat. Bad news!
Since elevated insulin itself doesn’t present a symptom and blood sugar can be maintained in the normal range for quite some time, most cases of insulin resistance are not diagnosed until weight changes are observed. Often insulin resistance is associated with other conditions — obesity, high blood pressure and/or high cholesterol. When all are present it’s considered “metabolic syndrome.” In women, polycystic ovary syndrome may be observed first, and insulin levels or blood sugar investigated as a follow-up.
In the United States, actual diagnoses of insulin resistance are about 3-16% among the general adult population. Insulin resistance can simply be missed until the pancreas falters and type 2 diabetes sets in with weight change, hunger and thirst as symptoms.
The diagnosis is not made from a single test. A physician may use symptoms corroborated with laboratory tests, such as blood sugar level to diagnose insulin resistance. The American Association of Clinical Endocrinologists (AACE) indicates the following clinical criteria for diagnosis of insulin resistance syndrome:
- Fasting glucose level of 110-126 mg/dL
- Glucose level of more than 140 mg/dL 2 hours after administration of 75 g of glucose
- BMI of 25 kg/m 2or higher
- Triglyceride level of 150 mg/dL or higher
- HDL-C level of less than 40 mg/dL in men or less than 50 mg/dL in women
- Blood pressure of 130/85 mm Hg or higher
Knowing that insulin resistance is usually present with other conditions, it is wise to follow-up with your healthcare provider if you have high blood pressure, high cholesterol or are overweight.
– Debbie J., MS, RD
This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your primary care physician.
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