Insulin resistance – disorder of carbohydrate metabolism
Lab tests required for evaluation: insulin level 0-60-120 min /blood sugar 0-60-120 min / HbA1
What is insulin resistance?
The normal level of blood sugar is very important for the proper function of the body. There are two basic hormones playing important rules in blood sugar control: insulin and glucagon (with opponent effect to insulin).
Insulin lessens the blood sugar level by promoting the sugar’s pass into the cells. In case of insulin resistance cells do not obtain enough sugar, so “starve”, as partly lesser insulin receptors have developed on the surface of the cells, partly the insulin receptors developed have changed, thus the insulin can only poorly connect to the insulin receptors. Due to these features the cells become insensitive, resistant to the insulin-effect, and substantially more insulin should be presented in the blood thereto an adequate quantity of sugar may pass into the cells.
Insulin resistance is more and more frequent, however many times it’s diagnosed too late. Its prevalence is roughly the same as that of diabetes, even greater than that. It is very important to diagnose it, because over a few years it can convert to diabetes.
One of the causes of the late diagnosis is that the blood sugar levels recognized at routine blood sugar examination and glucose tolerance test don’t refer unequivocally to the fluctuation of the insulin level.
Typically the physicians come aware of the problem, when the typical symptoms occur. For example the gynecologist or the endocrinologist become suspicious mainly because of menstrual disorder, infertility, ovarian cysts, hirsutism, overweight or depression. Insulin resistance typically affects mostly women, whom in case of overweight the problem can arise in young adulthood. Often this can lie behind even infertility!
The causes of insulin resistance: Insulin receptors of the cells haven’t formed out well, or don’t function appropriately.
The causes are the following:
- genetic predisposition – type 2 diabetes within the family may indicate
- physical inactivity
- inappropriate, high-fat diet
- inadequate vitamin D status
- gastrointestinal problems, disorders of the digestive system
- lactose and gluten intolerance
What symptoms may refer to insulin resistance?
- menstrual disorder, polycystic ovary syndrome
- infertility, having difficulty getting pregnant (74%!)
- overweight, notably the apple-shaped one, i.e. belly fat
- difficulties in losing weight
- sugar craving
- hunger attacks especially 2-3 hours after meal
- hirsutism, skin problems (e.g. spots)
- fatigue, sleeplessness
- decreased concentration
- malaise, inner turmoil
- hair loss
It’s carried out with blood test: glucose tolerance test. During the examination the blood insulin level and insulin secretion is recognized along the blood sugar levels as well.
Insulin resistance is reversible. After diagnosis life-style change, healthy diet and appropriate exercises needed, otherwise symptoms will intensify and there is a high chance, that diabetes type 2 will evolve. In practice that means, that after 10-15 years more than half of the patients with insulin resistance will have diabetes.
In women with insulin resistance 44 % apple shape abdominal obesity, 52% menstrual disorders and 74 % infertility or difficulties in getting pregnant can be observed.