First, what is insulin?
Insulin is a hormone made by the pancreas, an organ located just below and behind the stomach. Beta cells located within the pancreas are responsible for making insulin and releasing it into the bloodstream.
Insulin’s main function is to help the body digest food for energy. Thus, it is a key component needed for optimal metabolism. All the food we eat – carbohydrates, fats, proteins – is converted into glucose, a form of sugar that is able to be transported throughout the bloodstream and be used by the body’s cells. Glucose cannot enter a cell to “feed” the cell without insulin, which acts as the “key” unlocks the cell’s “door” to allow glucose to enter the cell. Without glucose or insulin, we would starve to death.
If we need insulin so badly, what causes the body to “resist” insulin?
Insulin resistance is a condition in which the body produces insulin in response to rising blood sugar levels, but the insulin is not being used effectively (i.e. the cells resist or don’t recognize the insulin). Usually this is due to an accumulation of years of elevated blood glucose, which the body is able to manage by making more and more insulin. Insulin is able to keep up with this for only so long, however. Rarely will a blood test show these high glucose levels until insulin resistance is starting to occur, which is why insulin resistance can remain hidden for years. But if blood insulin was checked **, you would likely see rising insulin levels. Eventually, the beta cells in the pancreas get burnt out/overworked, and they can’t keep up with the excess blood sugar. At this point, type 2 diabetes, usually occurs.
This is all still confusing. Is there another way to understand the process of insulin resistance?
Yes! Here’s the analogy I like to give, using an excerpt from a classic I Love Lucy episode. Click here for the video. As you watch the video, imagine this:
Glucose = chocolate
Insulin = Lucy and Ethel
As glucose production increases (represented by the increased speed of chocolate coming down the conveyer belt), Lucy and Ethel can initially keep up but eventually they have to do something with the glucose instead of packaging it up. The video is a perfect example of how insulin can not only keep up with all the chocolate/glucose production, but it also tends to lead to weight gain (as illustrated in the video with Lucy and Ethel stuffing the chocolate into their clothes/mouth). As you can imagine, eventually glucose gets by and builds up in the blood stream, and insulin gets “tired” of trying to keep up, leading to insulin resistance.
Are there symptoms associated with insulin resistance?
Most people don’t realize they have insulin resistance until it’s too late. There are no symptoms of insulin resistance, except for maybe weight gain, which can be attributed to a whole host of other conditions. If someone has severe insulin resistance, however, you may see dark patches on the skin, particularly around the back of the neck and in the axillae (armpits). This is known as acanthosis nigricans.
If there are no symptoms, how can we prevent insulin resistance?
The good news is that we can prevent this, particularly if we know the main contributors. The primary proposed causes of insulin resistance include:
-Poor nutrition/lifestyle choices
-Genetic predisposition to type 2 diabetes
-Excess weight around the waist (“belly fat”): over 40 inches for men, 35 inches for women
How do you test for insulin resistance?
The best ways to evaluate insulin resistance:
-Know your waist measurement and BMI
-Talk to your doctor about getting a sleep evaluation, even if you think you have no problems with sleep
-Get appropriate blood work, especially if you have any of the following risk factors
-Family history of type 2 diabetes
-Having a family background that includes Hispanic, African American, American Indian, Asian American, Pacific Islander American, or Alaska native
-History of gestational diabetes during pregnancy
-Having high blood pressure, or being treated for high blood pressure
-Having low levels of “good cholesterol” (HDL cholesterol) (below 35 mg/dL)
-Having high levels of triglycerides (above 150 mg/dl)
-Having polycystic ovarian syndrome (PCOS)
-Having a diagnosis as “borderline” diabetic (aka prediabetic)
Click this link for further information about insulin resistance, prediabetes, and what can be done about it: http://www.niddk.nih.gov/health-information/health-topics/Diabetes/insulin-resistance-prediabetes/Pages/index.aspx