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What Is Insulin Resistance and How Do You Know if You Have It?

If you've been on the internet recently, you've probably been aware of the issue of insulin resistance. Patients who take injectable medications like Ozempic speak about it. Fitness enthusiasts offer workout routines to reverse it. Influencers sell supplements that claim to combat the condition. What do you mean by insulin resistance? And what can you do to determine whether you suffer from it?


A Crucial Hormone


Insulin is a hormonal substance produced by the pancreas, vital for turning food into energy or storing the energy later.


The pancreas responds with insulin when blood sugar levels rise following a meal. The insulin, in turn, aids cells in utilizing sugar and reduces glucose levels in the bloodstream to an acceptable level.


If you're insulin resistant, your body's system doesn't react to insulin after meals as well as it ought to. Your cells aren't able to get sufficient glucose. The pancreas can then produce more insulin to speed the process forward. In time, the pancreas is incapable of keeping up. 

"After a number of years, your blood sugar starts to stay high after you eat, and that ultimately leads to what we call pre-diabetes," said Dr. Ruchi Mathur, an endocrinologist at Cedars-Sinai in Los Angeles.

A fasting blood glucose reading between 100 and 125 mg/dL is thought to be pre-diabetes. If the glucose levels do not improve and exceed the 125 mg/dL threshold, you could get diagnosed with Type 2 diabetes.


Who Should Be Concerned


As per the Centers for Disease Control and Prevention, 37.3 million adults have diabetes, and the number of people with 96 million -- more than a third of Americans have pre-diabetes. Since it is an insulin-resistant prelude to both conditions, researchers believe that the number of patients with insulin resistance is much greater.


"Most people don't even know they have it," said Dr. Mary Vouyiouklis Kellis, an endocrinologist at Cleveland Clinic.


Certain genetic conditions like myotonic dystrophy and lipodystrophy are often diagnosed with insulin resistance. However, more often, people suffer from insulin resistance due to the combination of biological and social circumstances that result from genetic and social factors, said Dr. Kellis.


For instance, if you have an ancestral experience of Type 2 diabetes, you could be more likely to suffer from insulin resistance. When you've had a diagnosis of high levels of fat in the bloodstream, for instance, high triglycerides, more elevated LDL cholesterol, and lower HDL cholesterol level, you could be more at risk. Black, Hispanic, American Indian, Alaska Native, and Asian individuals are thought to be at a higher risk.


The evidence suggests that insulin resistance is a sign of the onset of age and pancreatic function decreases. It is also more likely to develop in those who are not physically active or suffer from an unhealthy diet.

Certain medicines temporarily increase the risk of insulin resistance, such as a group of steroids referred to as glucocorticoids. Some antipsychotics, as well as some H.I.V. drugs, as the doctor. Kellis said. Certain hormonal and metabolic disorders result from insulin resistance, such as high blood pressure, heart disease, non-alcoholic fatty liver disease, polycystic ovary syndrome, or PCOS.


Early Signs to Look For


Doctors depend on a lot of the same signals and blood tests that are used to diagnose diabetes and pre-diabetes (such as the ones that measure your hemoglobin A1C levels or glucose levels -to determine whether you are suffering from insulin resistance. 

"It's a bit of art and science," Dr. Mathur said.

The United States Preventive Services Task Force recommends that all people between 35 and 70 years old be examined for pre-diabetes in those who are obese or overweight. The American Diabetes Association also suggests screening adults with any other factors associated with risk for the development of diabetes, like relatives who have Type 2 diabetes, a diagnosis of PCOS or having a history of gestational diabetes, or other clinical issues that can be linked to diabetes.


As per the A.D.A., all adults should begin testing at 45, even if they do not suffer from risk factors. If your results are in good shape, but you begin to notice signs or develop signs of diabetes risk, you must be tested at least once every three years.


There are often no evident symptoms until months or even years after your body struggles to control insulin levels and blood sugar. When they do come up initially, certain of the first indicators are likely to be correlated with how your body reacts to food.


You are tired or hungry constantly.


Because your body's metabolism isn't taking in glucose effectively, you cannot receive most energy boosters from your meals. Ultimately, you might feel exhausted, and your brain might constantly remind you to consume more sweet or carb-rich foods.


The weight you're carrying has increased.


Suppose your body starts running out of ways to keep extra glucose in the muscles, liver, and muscles. In that case, it begins to convert the excess glucose into fat. This could exacerbate the issue as more body fat could cause insulin resistance to become more severe.


Research suggests visceral fat, in particular, that surrounds the organs in the abdomen, releases hormones, fatty acids, and pro-inflammatory compounds in your blood. Chronic swelling and a rise in circulating fat are related to insulin resistance.


Although waist circumference isn't a way to determine health problems, doctors do utilize it to determine potential risks. Those with a waist size greater than 40 inches and non-pregnant women with a waist circumference of over 35 inches are thought to have a higher chance of diabetes resistance.

You may still have excessive levels of unhealthy weight in your cells even though your waist is slimmer, according to Dr. Gerald I. Shulman, Professor of Medicine at Yale and the co-director of Yale's Diabetes Research Center.


You notice darkened skin patches or skin tags.


People with higher levels of insulin resistance develop skin tags or the condition known as acanthosis. The state can manifest as dark spots in the folds of your body, like in the back or sides of the neck in between your arms or in the groin, the doctor said. Shulman said, adding that doctors frequently see the changes in the skin in those who suffer from PCOS and who suffer from insulin resistance.


Your period doesn't seem to be regular.


"Women's cycles are a close marker of their health," Dr. Mathur said. Suppose you are concerned that your menstrual cycles are changing or you have other indicators of PCOS like more facial hair or acne. In that case, doctors may test your hormone imbalances and the presence of insulin resistance.


Drink more water, or you have a greater urge to urinate.


If you are experiencing insulin resistance, your blood sugar levels rise. This could cause your kidneys to work harder, and you could get the urge to drink more water, and you'll urinate more often. If you suspect something is off and you think it may be related to insulin resistance, talk to your doctor. Mathur said. "You know your body better than anybody else."

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