Insulin resistance is a condition that occurs when the body’s cells become less responsive to insulin, a hormone produced by the pancreas that helps regulate blood sugar levels. It is linked to a range of lifestyle factors, including being overweight or obese and living an inactive lifestyle.
Insulin resistance is often considered a precursor to type 2 diabetes, a chronic disease that affects around 6% of people in the UK. But, it has also been linked to a range of other health problems, including cardiovascular disease, cancer, and cognitive decline.
Here, we look at health complications that can arise, how it is diagnosed and the treatment options available.
What health complications can result from insulin resistance?
One study published in the Journal of the American College of Cardiology found that insulin resistance was associated with an increased risk of cardiovascular disease, independent of traditional risk factors such as smoking and high blood pressure. The study also found that insulin resistance was associated with increased levels of inflammation and oxidative stress in the body, both of which are thought to contribute to the development of cardiovascular disease.
Another study published in the journal Nature Medicine found that insulin resistance was associated with an increased risk of cognitive decline in older adults. The study found that individuals with insulin resistance had lower scores on cognitive tests and a higher risk of developing Alzheimer’s disease and other forms of dementia.
While insulin resistance is often considered a precursor to type 2 diabetes, it is important to note that not all individuals with insulin resistance will develop diabetes. However, even in the absence of diabetes, insulin resistance can increase the risk of other health problems and should be addressed through lifestyle changes and, in some cases, medication.
How is insulin resistance diagnosed?
Insulin resistance is usually diagnosed through a combination of blood tests and physical exams. One common test used to measure insulin resistance is the fasting glucose test, which measures the level of glucose in the blood after a period of fasting. Another test that may be used is the oral glucose tolerance test, which measures how the body responds to a glucose load after fasting.
In addition to these tests, doctors may also perform a physical exam to look for signs of insulin resistance. These may include excess belly fat, high blood pressure, or abnormal cholesterol levels. Some doctors may also use more specialised tests to diagnose insulin resistance, such as the hyperinsulinemic-euglycemic clamp technique or the homeostasis model assessment of insulin resistance (HOMA-IR).
It is important to note that there is currently no standardised diagnostic criteria for insulin resistance. Some researchers have suggested using a combination of fasting glucose levels, insulin levels, and HOMA-IR scores to diagnose insulin resistance, but more research is needed to establish a clear diagnostic threshold.
What are the therapeutic options for insulin resistance?
The most effective treatment for insulin resistance is lifestyle changes, such as adopting a healthy diet, increasing physical activity, and maintaining a healthy weight. A diet rich in fruits, vegetables, whole grains, and lean protein sources can help improve insulin sensitivity and regulate blood sugar levels. Regular exercise, such as walking, cycling, or swimming, can also improve insulin sensitivity and promote weight loss.
After making lifestyle changes, medications may also be used to treat insulin resistance. Metformin, a medication commonly used to treat type 2 diabetes, has been shown to improve insulin sensitivity and reduce the risk of developing diabetes in people with insulin resistance. Other medications, such as thiazolidinediones and glucagon-like peptide-1 (GLP-1) receptor agonists, may also be used to treat insulin resistance.
What is the follow-up for insulin resistance?
Regular follow-up is important for individuals with insulin resistance to monitor their progress and ensure that their treatment plan is working effectively. This may involve regular blood tests to monitor glucose and insulin levels, as well as regular physical exams to monitor weight, blood pressure, and cholesterol levels.
Individuals with insulin resistance may also benefit from working with a healthcare provider, such as a dietitian or diabetes educator, to develop a personalised treatment plan. These healthcare providers can also provide ongoing support and education to help individuals with insulin resistance manage their condition and prevent complications.
The key is recognition and then action. Please do not hesitate to book an appointment with Dr Grosser if you are concerned or have any further questions.