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Introduction
Hello, I'm Dr. Eliana de Filippis, an endocrinologist at Mayo Clinic. In this video, we'll cover the basics of insulin resistance: what it is, who gets it, the symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available to understand insulin resistance, often referred to as pre-diabetes.
What is insulin resistance?
Let's first talk about what insulin does. When you eat food, your body converts the food into dietary sugars. Insulin is a hormone released by the pancreas that tells your cells to open up to that sugar and convert it into energy.
With insulin resistance, the cells don't react and don't open up, resulting in excess sugar in the blood. Over time, the pancreas keeps trying to regulate the blood sugar, producing more and more insulin until it wears out and can no longer produce large amounts of insulin. As a result, blood sugar levels increase to the point of being in the diabetic range.
Who gets insulin resistance? / Risk factors
Anyone can become insulin resistant. In particular, people with excess weight are at a higher risk compared to the general population. Risk is further increased with a family history of type 2 diabetes; age over 45; African, Latino, or Native American ancestry; smoking; and certain medications, including steroids, antipsychotics, and HIV medication.
There are other medical conditions associated with insulin resistance, like obstructive sleep apnea, fatty liver disease, polycystic ovarian syndrome, also known as PCOS, Cushing's syndrome, and lipodystrophic syndromes. Lipodystrophic syndromes are conditions that cause abnormal fat loss. So carrying either too much or not enough fat tissue in your body can be associated with insulin resistance.
Symptoms of insulin resistance
Very often, people with insulin resistance don't have any symptoms at all. It is usually picked up by their doctor during an annual health exam or routine blood work. There are some signs of insulin resistance that your doctor may look for. This includes a waistline over 40 inches in men and over 35 inches in women; skin tags or patches of dark, velvety skin called acanthosis nigricans; a blood pressure reading of 130 over 80 or higher; a fasting glucose level equal to or above 100 milligrams per deciliter, or a blood sugar level equal to or above 140 milligrams per deciliter two hours after the glucose tolerance test; an A1C between 5.7 and 6.3 percent; fasting triglycerides level over 150 milligrams per deciliter; an non-HDL cholesterol level over 130 milligrams per deciliter in men; and an HDL cholesterol level under 40 milligrams per deciliter in men and under 50 milligrams per deciliter in women.
How is insulin resistance diagnosed?
If your doctor spots these signs, they may follow up with a physical exam and a variety of blood tests that measure the levels of glucose, or sugar, in your blood, and/or your tolerance to that glucose, or, more recently, a blood test called hemoglobin glycosylated A1C, often simply referred to as A1C.
Treatment options
Reversing insulin resistance and preventing type 2 diabetes is possible through lifestyle changes, medication, or sometimes both. Healthy bodies come in different shapes and sizes. Losing weight through drastic means can be dangerous and counterproductive. Instead, get ideas from a doctor or a nutritionist about ways to incorporate healthy foods like fruits, vegetables, nuts, beans, and lean proteins into your meals. Also consider incorporating exercise and movement into your day-to-day life in ways that make you feel good.
Coping methods / What now?
Even though permanently defeating insulin resistance isn't always possible, you can help your body to be more receptive to insulin. Listen to your body, reduce stress, and give it the nutrition and the activity it needs.
Ending
If you'd like to learn even more about insulin resistance, watch our other related videos or visit mayoclinic.org. We wish you well.