Understanding Insulin Resistance

Insulin is the hormone that allows glucose to enter body cells for energy. If you are insulin resistant or insulin deficient (in the case of advanced type 2 diabetes or type 1 diabetes) glucose cannot properly enter body cells which results in abnormal blood glucose levels. Certain genetic and lifestyle factors contribute to the development of insulin resistance, which is the primary cause of type 2 diabetes.¹

Insulin resistance means that your body is still producing insulin; however, you are unable to use insulin effectively.² As a result, more insulin needs to be made by the pancreas to maintain normal blood glucose levels. As additional insulin is made and released, to maintain normal blood glucose levels, hunger and fat storage increases which contributes to unwanted weight gain and further worsening of insulin resistance. Eventually the body can no longer keep up with the increased insulin needs thus abnormal blood glucose levels ensue.

Symptoms of insulin resistance

Typically there are no symptoms for insulin resistance.² The following is a list of few symptoms that may indicate insulin resistance:²

• Acanthosis nigricans: a condition in which areas around the neck and armpits are darkened
• Skin tags: small skin growths around the neck and armpits
• Changes in eye sight

Risk factors for insulin resistance

• Being overweight or obese (in particular if there is excess weight/fat around the abdomen and surrounding organs)²
• Sedentary lifestyle
• Being over age 45
• Having a first degree relative with diabetes
• The following ethnic groups have a greater risk: African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American ²
• History of gestational diabetes (diabetes first diagnosed during pregnancy)
• Having the hormone disorder polycystic ovary syndrome (PCOS)²

How is insulin resistance diagnosed?

Blood tests to determine insulin resistance are typically reserved for research. If your doctor suspects that you are insulin resistant and therefore at risk for developing diabetes, he or she will likely complete one of the following tests:²

• Fasting blood glucose level
• A1c test
• Oral glucose tolerance test

What lifestyle changes can be made to help improve insulin sensitivity (thus reducing insulin resistance)?

• Weight loss
  • Weight loss, even a small amount (5 to 7 percent of your current body weight), can improve insulin sensitivity²
• Exercise:
  • In the short-term, exercise increases insulin sensitivity for up to 48 hours.
  • In the long-term, exercise will help promote muscle growth. Increasing your muscle mass will allow for greater glucose disposal, thereby increasing insulin sensitivity. ²
• Dietary changes that may improve insulin sensitivity:³
  • Fat
    • Reduce intake of saturated fat and trans fat
    • Increase intake monounsaturated fat and omega 6 polyunsaturated fat
  •  Carbohydrate
    • Increase intake of dietary fiber
  • Protein
    • A high protein diet may help in the short-term but in the long-term it is possible that eating a high protein diet may increase insulin resistance. More research is needed in this area.
  • Eating style
    • Mediterranean style eating plan
    • Low glycemic index diet
    • Low carbohydrate diet
  • Caffeine
    • Some research suggests that consuming greater than 200-300 mg of caffeine per day may increase insulin resistance. Therefore, if you regularly drink caffeinated beverages you may be able to enhance insulin sensitivity by reducing your daily intake  ⁴
• Alcohol
  • If consumed in moderation, alcohol may enhance insulin sensitivity (it may also increase risk of low blood glucose). It is important to first speak with your physician before consuming alcohol as some medications may interact with alcohol⁵
• Adequate sleep
  • Getting an adequate amount of sleep may help improve insulin sensitivity.
  • The recommended amount of sleep for adults, age 26-64, is 7-9 hours per night ⁶