Do you have difficulty losing abdominal fat? Do you crave sweets and carbohydrates on a daily basis? Do you feel sleepy after eating, or shaky when you go without food for several hours? Do any of your first-degree relatives (parents, siblings, children) have diabetes or escalating levels of central obesity? If you answered yes to one or more of these questions, then there is a high probability that you are one of the 80 million Americans with insulin resistance (otherwise known as prediabetes).
What is Insulin Resistance?
Insulin resistance is a condition in which your body becomes less able to utilize the insulin produced by your pancreas. This resistance, which develops in one out of every three American adults, results in a higher requirement of circulating insulin in order to maintain normal levels of glucose. Once your body is no longer able to compensate completely, your glucose levels become elevated and diabetes ensues.
What Are the Unhealthy Effects of Insulin Resistance?
Insulin is, by its very nature, an anabolic hormone. This means that its primary job is to build and store. Unfortunately, for most Americans, the principal effect of high insulin is the storage of central adiposity (fat). Simply put, the higher your circulating insulin levels, the higher your chances of developing the dreaded “tire” around your midsection. Insulin, in fact, plays a central role in all of the components of the “metabolic syndrome,” namely elevated fasting glucose, high blood pressure, high triglycerides, low HDL (good) cholesterol, and increased waist circumference. High insulin levels also contribute to elevated testosterone levels and irregular menstruation in women, polycystic ovarian syndrome, low testosterone levels (hypogonadism) in men, and low blood sugar (hypoglycemia). Insulin resistance has even been linked to many forms of cancer.
How Can Insulin Resistance Be Identified?
The best way to diagnose insulin resistance (prediabetes) is to actually measure insulin in the blood (normal fasting level is < 5 uIU/ml). Other helpful laboratory measurements include fasting glucose (normal < 100 mg/dl), HgbA1c (normal < 5.7%), and Glycomark (which approximates glucose peaks). Finally, a darkening of the skin creases in the neck, armpits, and/or groin (so-called acanthosis nigricans) is a reliable clinical sign of insulin overproduction.
Can Insulin Resistance Be Treated?
Fortunately, high insulin levels can be normalized with a combination of lifestyle optimization (low glycemic load diet and exercise as tolerated) plus or minus a medication called metformin. By aggressively treating at this early stage, you can prevent (or at least postpone) the progression to diabetes.
About Dr. Tanton
Damon Tanton, MD, is board-certified in endocrinology, diabetes and metabolism and serves as the medical director of clinical practice at the Florida Hospital Diabetes Institute. To learn more and to make an appointment, call (407) 303-2801.