Insulin resistance: Understanding symptoms, causes, treatment

Insulin resistance has become a growing concern in today’s society, with its prevalence on the rise. As the prevalence of obesity and sedentary lifestyles continues to increase globally, so does the incidence of insulin resistance. 

This metabolic disorder causes the body’s cells to become less responsive to the effects of insulin, resulting in elevated blood sugar levels.

Common indicators include unexplained weight gain, especially around the abdominal area, difficulty losing weight despite efforts, consistently high blood sugar levels, persistent fatigue and low energy levels, increased hunger and food cravings, and skin changes such as darkened patches known as acanthosis nigricans. 

This article goes deep into the different aspects of insulin resistance, signs and symptoms, diagnostic methods, health conditions if left untreated, treatment options and preventive measures. 

What is insulin?

A metabolic disease known as insulin resistance occurs when the body’s cells stop responding to the effects of insulin. 

In other words, the “key” that insulin offers to unlock the cells and permit glucose access begins to fit less snugly [1]. Because of this, glucose cannot enter the cells as effectively as it should even when insulin is there.

The pancreas first overcomes this resistance by making more insulin and releasing it into circulation. 

Since blood sugar levels are kept within a normal range by this overproduction, early-stage insulin resistance might go undiagnosed.

However, with time, the pancreas may get overworked due to the ongoing need for more insulin, which can eventually wear down its insulin-producing cells. 

Consequently, there would be a gradual decline in blood insulin levels and an increase in blood sugar levels, which, if untreated, can progress to type 2 diabetes or prediabetes.

The effects of insulin resistance, nevertheless, transcend beyond glucose regulation. Given that insulin is involved in the metabolism of fat, insulin resistance can also result in a rise in the blood’s concentration of free fatty acids, which can cause a number of health issues, including heart disease [2].

What is the role of insulin in the body?

The human body generates the hormone insulin in the pancreas, especially in its beta cells. It is an important participant in our metabolic processes, especially in the control of blood sugar or glucose.

Biological function

Following ingestion, food is broken down into a variety of nutrients, including glucose, which is absorbed into the circulation. 

The pancreas releases insulin in response to the rise in blood glucose levels. Insulin works as a key to unlock our body’s cells, enabling glucose to enter and be used as fuel. 

By successfully lowering blood glucose levels, this procedure preserves the equilibrium that our body needs to function properly [3].

metabolic function
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Metabolic function

In addition to controlling blood sugar levels, insulin is important for the metabolism of both fat and protein. 

It slows the breakdown of fat and stimulates protein synthesis while encouraging the storage of extra glucose as glycogen in the liver and muscles. 

In essence, insulin plays a crucial role in how well our body uses the energy that comes from the food we eat.

What are the common causes of insulin resistance?

Individuals can prevent or treat insulin resistance by taking preventative actions by being aware of these reasons. Below are some common causes of insulin resistance:

1. Genetic factors 

Although hereditary susceptibility to this metabolic condition might also exist, lifestyle decisions play a key impact in the emergence of insulin resistance. 

Numerous gene mutations that can affect how the body makes and uses insulin have been found through research. 

These genetic variables may have an impact on several components of insulin signaling and glucose metabolism, increasing the risk of insulin resistance in certain people. 

The following are a few genetic components connected to insulin resistance:

  • Gene variations in insulin receptor signaling: A protein on the outside of cells called the insulin receptor attaches to insulin and starts a signaling cascade that permits the absorption and metabolism of glucose [4].

    Reduced insulin sensitivity can result from mutations in the genes producing the insulin receptor or proteins involved in its signaling pathway, raising the chance of developing insulin resistance.
  • Glucose transporter gene mutations: Proteins called glucose transporters make it easier for glucose to cross cell membranes.

    The most well-known glucose transporter, known as GLUT4, is mostly present in adipose and muscular tissue. Insulin resistance is a result of impaired glucose absorption caused by genetic differences in the genes encoding glucose transporters.
  • Mitochondrial dysfunction: Adenosine triphosphate (ATP), the main energy unit of the cell, is produced by mitochondria, which are the energy-producing parts of cells.

    The activity of the mitochondria can be impacted by several gene abnormalities, which can diminish energy generation and impede insulin signaling. Insulin resistance and a higher risk of type 2 diabetes may come from this.

2. Lifestyle factors 

The onset and progression of insulin resistance are significantly influenced by a number of lifestyle variables. 

Modifying these characteristics, which are frequently connected to our routines and everyday behaviors, can have a significant impact on how susceptible we are to insulin resistance.

  • Dietary Habits: Weight gain and consequently insulin resistance can result from eating a diet heavy in processed foods, saturated fats, trans fats and simple sweets.

    These foods increase insulin and blood sugar levels, which causes the cells to become less sensitive to insulin.
  • Physical inactivity: Insulin resistance can result from the body’s cells losing their sensitivity to insulin without frequent activity.

    Regular exercise makes cells in the body more receptive to insulin, enabling them to absorb more glucose for energy. 
  • Sleep: The body’s hormonal balance, including insulin, is controlled while you sleep. These procedures can be disturbed by sleep deprivation resulting in insulin resistance.
  • Stress: Chronic stress, whether mental or emotional, can throw off the body’s hormonal balance, which includes the hormones that control insulin and blood sugar levels. This may eventually lead to the emergence of insulin resistance.
  • Smoking: Inflammation of the pancreas can result from smoking, according to research. Although the precise processes are still being investigated, smoking is thought to contribute to inflammation and oxidative stress in the body, both of which can hinder insulin’s ability to operate.
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3. Obesity

Insulin sensitivity is significantly impacted by excess body fat, especially visceral adipose tissue (fat surrounding the abdominal organs), which can result in insulin resistance [5].

Adipokines, which include inflammatory chemicals like tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) are secreted by adipose tissue in obese people. 

Insulin resistance can result from these inflammatory adipokines’ interference with insulin signaling pathways.

4. Medical conditions

The probability of developing insulin resistance might also be increased by specific medical disorders and risk factors. 

There are several of them, such as the polycystic ovarian syndrome (PCOS), a history of gestational diabetes, cardiovascular disease and a few metabolic syndrome components. Insulin resistance can also be influenced by stress and aging.

What are the common signs and symptoms of insulin resistance?

In its early stages, insulin resistance may not show any obvious signs and frequently develops gradually. 

But when the illness worsens, specific signs and symptoms could emerge. It’s crucial to keep in mind that these symptoms might differ from person to person and that some people may experience them more severely than others. 

Here are some typical insulin resistance warning signs and symptoms:

Increased hunger

Insulin resistance can impair the natural communication between the brain and insulin, increasing desires for sweet or carb-rich meals in particular and causing an increase in appetite.

Weight gain or difficulty losing weight 

Particularly around the abdomen, insulin resistance can be a factor in weight gain. Despite their best efforts, people with insulin resistance may find it difficult to reduce extra weight, regardless of what they do in the way of food and exercise.

Fatigue and low energy levels

Feelings of exhaustion and low energy might persist throughout the day as a result of fluctuating blood sugar levels and the body’s inability to efficiently utilize glucose.

Frequent urination

Higher blood sugar levels brought on by insulin resistance might make the kidneys work harder to filter and eliminate the extra glucose. Increased urination, especially at night (nocturia), may result from this.

Increased thirst

Increased thirst may result from increased urine brought on by insulin resistance as the body seeks to replace lost fluids.

Brain fog and difficulty concentrating

The brain’s ability to focus, remember things, and think clearly can all be impacted by insulin resistance [6]. Some people could feel like they have “brain fog” or just generally have slow cognitive function.

Skin changes

Acanthosis nigricans, or darkened patches of skin, can appear on the neck, groin or armpits. Frequently, the texture of these patches is velvety.

Recurrent infections 

Due to impaired immune function brought on by insulin resistance, people are more likely to contract infections often, especially yeast infections (like candidiasis) and urinary tract infections (UTIs).

High blood pressure

Hypertension risk can be increased by insulin resistance and the resulting metabolic disruptions, which can raise blood pressure levels.

Menstrual irregularities

Infertility problems and disorders like polycystic ovarian syndrome (PCOS) may result from women’s irregular menstrual cycles or disturbances in hormone levels caused by insulin resistance.

What happens if you have unchecked insulin resistance?

If untreated, insulin resistance can have a negative impact on general health and raise the chance of contracting a number of illnesses. 

Here are some possible effects of untreated or improperly managed insulin resistance:

Type 2 diabetes 

One of the main risk factors for type 2 diabetes is insulin resistance. As insulin resistance worsens, the pancreas may find it difficult to create enough insulin to make up for it, which might result in consistently high blood sugar levels. This can eventually lead to the emergence of type 2 diabetes.

Cardiovascular Disease

An elevated risk of cardiovascular disease, including illnesses like heart disease, heart attacks and strokes, is directly correlated with insulin resistance.

Insulin resistance encourages inflammation, elevated blood pressure, and aberrant lipid profiles, all of which lead to the buildup of plaque in the arteries.

Polycystic Ovary Syndrome (PCOS)

One defining characteristic of PCOS is insulin resistance. Incorrect menstruation cycles, infertility, excessive hair growth, acne and ovarian cysts are all results of it upsetting the body’s delicate hormonal balance. Additionally, PCOS patients are more likely to develop diabetes

Non-Alcoholic Fatty Liver Disease (NAFLD)

Fat can build up in the liver as a result of insulin resistance, which can result in non-alcoholic fatty liver disease. Simple fatty liver can develop into more severe forms of the disorder, such as non-alcoholic steatohepatitis (NASH), liver fibrosis and cirrhosis.

Kidney disease

Long-term insulin resistance raises the chance of developing chronic renal disease and contributes to kidney damage. The fragile blood arteries in the kidneys can be harmed by persistently high blood sugar levels and high blood pressure linked to insulin resistance.

Sleep apnea

The illness known as sleep apnea, which is marked by pauses in breathing while you sleep, is frequently linked to insulin resistance. Since sleep apnea can also cause insulin resistance, the two disorders are inversely correlated [7].

sleep apnea
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Neuropathy

Diabetes and uncontrolled insulin resistance can harm the nerves all over the body, causing neuropathy. This disorder can lead to tingling, numbness, discomfort, and weakness; it often first manifests in the hands and feet but may also spread to other body parts. 

Cognitive Decline

There may be a connection between cognitive decline and insulin resistance, according to recent research. Neurodegenerative conditions like Alzheimer’s disease may be facilitated by insulin resistance.

What are the diagnostic methods for insulin resistance?

A combination of clinical evaluation, laboratory testing, and assessment of related risk factors is commonly used to diagnose insulin resistance. Here are some typical tests for determining insulin resistance:

  • Medical history and physical examination

A medical expert will examine your physical and evaluate your medical history, including any symptoms you may be having, to look for any indications of insulin resistance, such as acanthosis nigricans (darkened skin patches).

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  • Fasting blood glucose test

After an overnight fast, this test analyzes your blood sugar level. Elevated fasting blood glucose levels can be a sign of insulin resistance since they show a problem with the body’s ability to control blood sugar levels.

  • Oral Glucose Tolerance Test (OGTT)

Before and after ingesting a beverage high in glucose, the OGTT tests your blood sugar levels. This examination offers a more thorough evaluation of your body’s glucose tolerance and can detect insulin resistance and poor glucose tolerance.

  • Insulin levels and HOMA-IR

Insight into insulin resistance can be gained by measuring fasting insulin levels alongside fasting blood glucose levels. Fasting insulin and glucose levels are used to produce the homeostatic model assessment of insulin resistance (HOMA-IR), an indicator used to measure insulin resistance [8].

  • Glycated Hemoglobin (HbA1c)

According to the HbA1c test, blood sugar levels have been on average over the previous few months. Elevated HbA1c values might be a sign of prediabetes or insulin resistance.

  • Lipid profile

Low levels of high-density lipoprotein (HDL) cholesterol and aberrant lipid levels, such as increased triglycerides, are frequently linked to insulin resistance. These lipid indicators can be evaluated with a lipid profile test.

  • Other biomarkers

To evaluate elements connected to insulin resistance, such as inflammatory indicators, liver function and renal function, further tests may be required.

Treatment options for insulin resistance

Combining lifestyle changes with medicine and, occasionally, the therapy of underlying problems is how insulin resistance is treated.

Enhancing insulin sensitivity, controlling blood sugar levels and lowering the danger of related health consequences are the main targets of therapy. 

Here are a few common insulin resistance treatments:

Medications 

To increase insulin sensitivity and manage blood sugar levels, certain drugs may be administered. These may consist of:

  • Metformin: As a first-line treatment, metformin aids in lowering the liver’s synthesis of glucose and improves the body’s tissues’ sensitivity to insulin.
  • Thiazolidinediones: A family of drugs called thiazolidinediones (TZDs) increases insulin sensitivity and decreases insulin resistance. They function by enhancing glucose absorption by focusing on certain receptors in the body’s cells.
  • GLP-1 Receptor Agonists: These Injectable drugs increase insulin sensitivity and enhance insulin production. They also help in weight loss, which is beneficial for those obese.
  • DPP-4 Inhibitors: By inhibiting the enzyme that breaks down GLP-1, a hormone that increases the release of insulin, DPP-4 inhibitors help control blood sugar levels.

Lifestyle modifications

  • Balanced diet: A balanced diet should contain whole, high-fiber foods, lean proteins and healthy fats while minimizing processed foods, added sugars and refined carbs will help control blood sugar levels and encourage weight reduction.
  • Regular exercise: Regular physical exercise helps regulate weight, increases glucose absorption by cells and improves insulin sensitivity. For best results, try to mix strength training with cardiovascular activity.
  • Weight management: Getting rid of extra pounds, especially belly fat, can greatly increase insulin sensitivity. Managing insulin resistance requires achieving and keeping a healthy weight through a mix of food and exercise.

Blood sugar monitoring

Monitoring blood sugar levels often can give important information about how well the body is responding to therapy and assist direct changes to medication or lifestyle.

Managing underlying conditions

Specific management tactics for reproductive conditions like polycystic ovarian syndrome (PCOS) or cardiovascular disease may be added to the treatment plan if insulin resistance is linked to those conditions.

Education and support

It is essential to educate people about insulin resistance, how to manage it, and how to change their lifestyles. Throughout the course of therapy, help from healthcare experts, dietitians, diabetes educators and support groups can offer direction, encouragement and support.

What are the prevention strategies for insulin resistance?

In order to preserve general health and lower the chance of acquiring type 2 diabetes and other related diseases, preventing insulin resistance is a crucial strategy. 

Even though certain things, including genetics, are beyond a person’s control, there are a number of proactive measures they may take to stop or postpone the development of insulin resistance. 

Here are a few preventative measures:

  • Regular exercise
  • Limit alcohol consumption
  • Education and awareness
  • Regular health check-ups
What are the prevention strategies for insulin resistance?

What is it like living with insulin resistance?

Maintaining good health and reducing the risk of consequences while living with insulin resistance involves proactive management and the adoption of healthy practices. When dealing with insulin resistance, it’s important to keep the following things in mind:

  • Management strategies and coping mechanisms

Put tactics into practice daily to control insulin resistance successfully. This can entail following a balanced diet, exercising frequently, taking prescription medications as prescribed, and routinely checking blood sugar levels. 

Create coping strategies to handle any difficulties or emotional stress brought on by having a chronic illness.

  • Long-term health implications

Work closely with healthcare providers to monitor and manage linked illnesses including type 2 diabetes, cardiovascular disease, and PCOS. 

Recognize the possible long-term health effects of insulin resistance. It is crucial to have regular check-ups, screenings and proper management of these illnesses.

  • Emotional and psychological aspects

Having insulin resistance might occasionally provide emotional and psychological difficulties. 

It’s critical to deal with any annoyance, worry, or tension that can surface. To manage the emotional components of managing insulin resistance, seek assistance from healthcare experts, diabetes educators, support groups or therapists. They may offer direction and aid in this regard.

Takeaway

Insulin resistance occurs when the body’s cells become less responsive to the effects of insulin, a hormone that regulates blood sugar levels. 

Factors such as obesity, sedentary lifestyle, unhealthy diet, genetics, and certain medical conditions contribute to the development of insulin resistance.

Medications and treatment options, such as metformin, insulin therapy, and emerging approaches, may be prescribed by healthcare professionals to manage insulin resistance. 

Early detection and intervention are key to preventing the progression of insulin resistance into more severe conditions. Remember, your health is in your hands, and with the right knowledge and proactive measures, you can unlock a healthier, insulin-responsive future.

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[1] https://www.medicalnewstoday.com/articles/323760
[2] https://www.ncbi.nlm.nih.gov/books/NBK507839/
[3] https://www.healthline.com/health/type-2-diabetes/insulin
[4] https://www.cdc.gov/diabetes/basics/insulin-resistance.html
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1204764/
[6] https://www.healthline.com/health/diabetes/brain-fog-diabetes
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767932/
[8] https://emedicine.medscape.com/article/2089224-overview

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