What is it?

Insulin is produced by the pancreas to lower blood glucose levels, which rise after a meal and keep them in the normal range. Insulin resistance occurs when cells begin to respond poorly to it and stop receiving glucose. To help it be absorbed, the pancreas begins to produce more insulin to compensate.

What should be alarming?

Thousands of people live without knowing they have insulin resistance. There is no change in well-being or obvious symptoms. The only visible signs are patches of dark, velvety skin (black acanthosis), excess body weight with increased appetite, and blood pressure of 130/80 or higher.

Insulin resistance leads to the development of serious diseases and, if a person is at risk, he or she should be screened regularly to establish or rule out its presence — especially if health problems already exist.

Who is at risk?

Heredity and ethnic predisposition (Africans, Hispanics, and Native Americans are more likely to have insulin resistance) are circumstances that cannot be influenced. But lifestyle, which is directly related to the development of insulin resistance, can and should be corrected. Risk factors include the following:

• Obesity, especially abdominal obesity
• Sedentary lifestyle
• Consumption of foods high in carbohydrates
• Gestational diabetes
• Nonalcoholic fatty liver disease
• Polycystic ovarian syndrome
• Smoking
• Age over 45 years
• Hormonal disorders such as Cushing's syndrome and acromegaly
• Taking certain medications such as steroids, neuroleptics, and HIV medications
• Sleep problems, such as sleep apnea

How is it diagnosed?

In order to determine for sure the presence of insulin resistance, it is necessary to undergo an examination by an endocrinologist. Women will also need to visit a gynecologist. The following tests may be issued: insulin and sugar levels, C-reactive protein, glycated hemoglobin, the level of "good" cholesterol, and triglycerides.

The following indicators should suggest poor insulin absorption:

• fasting glucose levels greater than 5.55 mmol/L
• fasting triglyceride level more than 1.7 mmol/L
• HDL cholesterol level below 1.03 mmol/L

What are the dangers?

Infertility. There is a direct link between insulin resistance and the female reproductive system. Typically, insulin insensitivity is accompanied by polycystic ovarian syndrome (PCOS), infertility, and disorders of sex hormones. All of these abnormalities make it impossible to conceive and bear a child. Women with PCOS tend to have elevated testosterone levels, irregular or absent periods, large waist circumference, male-type hair loss, acne, and excessive facial and body hair.

Prediabetes. This usually occurs when there is already resistance to insulin, or when increased insulin production over many years eventually leads to depletion of the secretory apparatus of the beta cells of the pancreas. In this case, excess glucose remains in the bloodstream and does not reach the cells. The glucose level is higher than normal, but not high enough to be diagnosed as diabetes. As a consequence, there is a high risk of developing type 2 diabetes. In the United States, more than 84 million people age 18 and older have prediabetes. That's about one in three adults.

What can you do about it?

Reversing insulin resistance and preventing type 2 diabetes is doable. Keep the following tips in mind:

• Get at least 30 minutes a day of physical activity (such as brisk walking).
• Get your weight back to normal, preferably under the supervision of specialists. Stick to a healthy diet. Include fruits, vegetables, whole grains, nuts, legumes, and fish in your diet.
• Be sure to control your blood sugar level on an empty stomach and after meals.
• Get enough sleep: a night "fast" should be at least 7-8 hours.
• Finally, your eating regimen is extremely important. Nothing prevents the development of insulin resistance like the "hunger window" of interval fasting. Switch to interval fasting, as long as you have passed a checkup and received permission from your doctor (you can read about contraindications to an interval fasting regimen on our website).

14 June 2022