What is insulin resistance?
Insulin resistance is when the body doesn’t respond correctly to the messages that insulin is trying to deliver. Even if your glucose levels are normal, lab work and screenings can provide clues that point to insulin resistance. This can help you take preventive measures to turn around insulin resistance before it affects your glucose.
Medically reviewed by Dr. Roshani Sanghani, American Board-Certified in Endocrinology, Diabetes, and Metabolism ·
What does insulin normally do?
Insulin is a life-saving hormone. We all need it to stay alive. Food is what triggers the pancreas to begin sending metabolic messages via insulin to the main insulin response organs: liver, muscle, and fat. In a normal healthy body, insulin can signal in little minute doses, get the job done very effectively, move the food that we have eaten, specifically the energy that comes after we digest the food. That energy needs to be parked inside the cells. Insulin helps escort that energy inside.
High insulin levels will tell the body to store energy. Low insulin levels will tell the body to release and burn energy.
What happens in insulin resistance?
When we have insulin resistance, insulin is trying to make the communication work. The pancreas is trying harder. It’s starting to shout. It’s starting to raise its voice. Insulin levels are creeping up, but the cells are not listening. Glucose starts to rise. This is high insulin, high glucose. Everybody’s shouting, nobody’s listening. That’s insulin resistance.
How can insulin resistance show up?
Insulin resistance is at the core of progressive uncontrolled diabetes and multiple chronic medical conditions.
- Blood glucose that keeps climbing even when you’re doing everything rightInsulin resistance is what makes Type 2 and Type 1 Diabetes progressively difficult to manage; addressing insulin resistance helps you turn around diabetes.
- Cravings that feel like a willpower problem but aren’tOnce insulin resistance is reached, it causes leptin resistance, which makes the brain feel like it’s hungry, starving, and craving food all day.
- Weight that won’t move, especially around the middleHigh insulin levels cause insulin resistance and signal the body to store fat.
- PCOS (now called PMOS) symptoms put down to “just the ovaries”PCOS is considered to be a form of insulin resistance at the ovarian level, but insulin resistance is not part of the criteria to be diagnosed with PCOS.
- Fatty liver picked up on a scan you weren’t expectingIn insulin resistance, the liver is holding excess glucose from the meals as fatty liver for years before the HbA1c starts to climb.
Can insulin resistance improve?
Getting metabolically sick is not your fault, but there is plenty you can do about it. Different lifestyle choices within nutrition, sleep habits, stress management, and exercise can keep people confined in a vicious cycle of insulin resistance. The four wheels of the lifestyle car with the fifth optional element of fasting show you how to turn around insulin resistance and uncontrolled diabetes. Most cases of Type 2 Diabetes can go into remission, as long as the pancreas is still making enough insulin.
Changing your food is a very powerful way to change your blood glucose levels. Do not do this without medical supervision. Your doctor needs to adjust your current medication to make sure you don’t develop dangerously low blood glucose (hypoglycemia) as the levels come down with the changes you make.
How is insulin resistance assessed?
The HOMA-IR index is a measure of insulin resistance. The TG/HDL ratio is a reliable marker of insulin resistance and is available on standard lipid panels.
Frequently asked questions
The majority of people walking around with metabolic ill health don’t have any signs or symptoms. They feel fine. And that’s one of the catches about this: we may have to go screen for it even when someone feels absolutely fine. But maybe some things to think about are a bit of difficulty losing that belly fat or weight around the midsection that just refuses to go, feeling tired all the time, or noticing that you’re just putting on weight, doing exactly the same thing. These would be some signs. Of course, if you have a family history, these are reasons to go looking for it. But I don’t want people waiting for signs and symptoms of it, actually.
We can inherit a tendency for insulin resistance from our parents. Some of that tendency is coded in our DNA, and some of the tendency is coded in the habits we learn while growing up. Modern lifestyles are keeping us stuck.
In cases of Type 2 Diabetes, people start with insulin resistance, which causes weight gain, while in Type 1 Diabetes, people start storing excess fat in the body if they’ve been exposed to excess insulin. Although everyone with diabetes and excess body fat is told to “eat less and move more,” or to simply “lose weight,” those two-word phrases are not enough to get the job done.
Menopause has been associated with an increased risk of insulin resistance, inch gain around the waist, and decreased muscle mass. The good news is that the drop in estrogen and progesterone doesn’t have to mean an inevitable increase of excess body fat or a permanent decline in mental or physical performance.
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