What Is Insulin Resistance?
Insulin resistance is not a disease or specific diagnosis
, but it has been associated with conditions such as cardiovascular disease, hypertension, polycystic ovarian syndrome, type II diabetes, obesity, and nonalcoholic fatty liver disease. Some researchers also believe that there may be a linkage between insulin resistance and some forms of cancer.
The mechanisms of these relations, however, are not well understood. It is important to remember that many of the people who have these circumstances do not have insulin resistance and, likewise, many of the people who have insulin resistance will never develop these conditions.These are just patterns of association that have emerged.They are frequently seen together and it is thought that insulin resistance may add to their development and intensify them when it is present.
Insulin resistance is also low hdl, or good cholesterol, and high levels of another blood fat called triglycerides.The insulin resistance syndrome can result in atherosclerosis (hardening of the arteries) and an increased risk of blood clots. A major factor in the development of insulin resistance syndrome is obesity -- especially abdominal obesity or belly fat.
Obesity promotesinsulin resistance and negatively affects insulin responsiveness in a person. Weight loss can improve the body's ability to recognize and use insulin appropriately
What Is Insulin?
Insulin is a hormone produced by the pancreas that regulates the level of glucose, a simple sugar that provides energy, in the blood. The human body requires a steady amount of glucose throughout the day, and that glucose comes from the foods people eat. Obviously, though, people do not spend the entire day eating a bit of food at a time to maintain a steady stream of glucose. This is where insulin comes in.
How Do You Test For Insulin Resistance?
There is no one test that can directly detect insulin resistance. Instead, a doctor will look at a patient's entire clinical picture and may deduce that the patient has insulin resistance if he has increased glucose levels, increased levels of triglycerides and LDL, and decreased concentrations of HDL.
Laboratory tests most likely to be ordered contain: Glucose. This is usually performed fasting but, in some cases, a doctor may also order a glucose tolerance test - several glucose tests that are taken before and at timed intervals after a glucose challenge.The goal of glucose testing is to determine whether a patient has an impaired response to glucose.
Lipid profile.This measures the HDL, LDL, triglycerides, and total cholesterol.If the triglycerides are significantly elevated, a DLDL direct measurement of the LDL) may need to be done. One of the most common ways of detecting insulin resistance is by using the homeostatic model assessment (HOMA). It involves measuring glucose and insulin levels and then using a calculation to estimate beta cell function and insulin sensitivity.
Other laboratory tests that may be ordered to help evaluate insulin resistance and provide additional information include: The fasting insulin test.It is variable, but insulin levels will usually be elevated in those with significant insulin resistance.
hs-CRP. This is a measure of low levels of inflammation that may be done as part of an evaluation of cardiac risk. It may be increased with insulin resistance.
sdLDL. This is a measurement of the number of small dense low-density lipoprotein molecules a patient has.This test is not ordered frequently but may be measured as part of a lipoprotein subfractions test.
Insulin tolerance test (ITT). Not widely used but is one method for determining insulin sensitivity (or resistance), especially in obese individuals and those with PCOS.
This test involves an IV-infusion of insulin, with subsequent measurements of glucose and insulin levels. Specific insulin suppression tests may also be ordered in a research setting to study insulin resistance but are not generally used in a clinical setting.
What Is The Treatment?
Treatment of insulin resistance principally involves changes in diet and lifestyle. The American Diabetes Association (ADA) recommends losing excess weight, getting regular amounts of moderate-intensity physical activity, and increasing dietary fiber to lower blood insulin levels and increase the body's sensitivity to it.
Weight loss and regular exercise can: Decrease blood pressure levels Increase insulin sensitivity Decrease triglyceride LDL levels and Raise HDL levels
Patients who are determined by their doctors as having insulin resistance should work with their doctor and with other medical professionals, such as a nutritionist, to develop an individualized treatment plan and to monitor its effectiveness. Drug treatments may also be necessary to control any existing, fundamental, associated conditions, and diseases.
by: Bill Hammons
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