Insulin ResistanceWhat is Insulin Resistance? Before answering this question directly, let's first explain what is insulin. Insulin is a special hormone that everyone needs. It is normally made by your pancreas, a small organ in the abdomen. Without this hormone, your body cannot control or properly use glucose (sugar) – one of its most important sources of energy. Who needs to take this hormone? People with Type 1 diabetes don't make enough insulin themselves, so their main treatment is to replacement it artificially. If you do not replace this special hormone that your body needs, your blood sugar will rise because the glucose cannot get out of the blood and into the cells. The cells will sense this lack of energy and will instruct the body to burn any stored fat to try to get more energy. After a few days of this, a very dangerous condition called diabetic ketoacidosis can develop. So replacement medication is an absolute necessity for these people. Do people with Type 2 diabetes have insulin resistance? In Type 2 diabetes the problem is not a lack of insulin, but increasing resistance of your cells to its effects. What this means is, the cells do not respond to it as they should, so that more and more of the hormone is required to get sugar out of the blood and in the cells. We can think of insulin as a key that opens the door to the cells through which glucose/sugar leaves the bloodstream to enter the cell. Insulin resistance, then, is a malfunction of the "lock" on the cells that prevents the insulin "key" from opening it and letting in glucose/sugar. Early in the course of diabetes type 2, the body can compensate for insulin resistance by producing more insulin from the pancreas. But after a while, unless lifestyle changes are adopted to help the cells become more responsive, the pancreas tires out and becomes unable to cope with the ever-increasing need for more insulin. About one-fourth of people with Type 2 diabetes eventually need treatment with insulin as a result of progressive (worsening) insulin resistance. The longer a person has Type 2 diabetes, the more likely they will have to start insulin treatment at some point. You can avoid the need for insulin treatment altogether by making lifestyle choices now that decrease excess sugar in the blood and sensitize your cells to the effects of insulin. Type 2 diabetes is sometimes defined as the form of diabetes that develops when the body does not respond properly to insulin, as opposed to type 1 diabetes, in which, as we have said, the pancreas makes almost no insulin at all. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to produce enough insulin in response to meals. This can also occur in people who have type 1 diabetes, especially if they are overweight.
Because insulin resistance tends to run in families, we believe that genes may be partly responsible. Being overweight can also be a risk factor. And excess body fat along with a lack of exercise decrease your muscles' ability to use insulin.
Just as we discovered with diabetes, these precursor conditions usually have no symptoms. It is possible for you to have one or both conditions for several years without noticing anything different. If you have mild or moderate insulin resistance, blood tests may show normal or high blood glucose in conjunction with high insulin levels. (The high insulin levels are due to the body's efforts to compensate for cells' poor response to normal insulin). With a more severe form, you can develop dark patches of skin over the back of joints like elbows, knees, knuckles - but the most common site is on the back of the neck. This condition is called acanthosis nigricans - an almost certain sign of insulin resistance. Do you have Pre-diabetes? If you are 45 years or older, you should consider getting tested for diabetes - especially if you are also overweight. On the other hand, if you are younger than 45 but you are overweight and have any of the following risk factors, you should also get tested:
Is Insulin Resistance Reversible? Yes. Physical activity and weight loss make the body more responsive to insulin. By losing weight and becoming more physically active, you may avoid progressing from insulin resistance to development of outright type 2 diabetes. As a matter of fact, a major research study has confirmed the benefits of healthy lifestyle changes and weight loss. In 2001, the National Institutes of Health completed the Diabetes Prevention Program (DPP), which was designed to find the best ways to prevent type 2 diabetes in overweight people with pre-diabetes. The researchers found that lifestyle changes reduced the risk of diabetes by a whopping 58 percent! With lifestyle changes, many people with pre-diabetes returned to normal blood glucose levels. The main goal in treating insulin resistance and pre-diabetes is to help your body relearn to use insulin normally. You can do several things to help reach this goal:
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