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Insulin resistance is a silent condition that increases
the chances of developing diabetes and heart disease. Learning
about insulin resistance is the first step you can take toward
making lifestyle changes that will help you prevent diabetes
and other health problems.
What does insulin do?
After you eat, the food is broken down into glucose, the
simple sugar that is the main source of energy for the body's
cells. But your cells cannot use glucose without insulin,
a hormone produced by the pancreas. Insulin helps the cells
take in glucose and convert it to energy. When the pancreas
does not make enough insulin or the body is unable to use
the insulin that is present, the cells cannot use glucose.
Excess glucose builds up in the bloodstream, setting the
stage for diabetes.
Being obese or overweight affects the way insulin works
in your body. Extra fat tissue can make your body resistant
to the action of insulin, but exercise helps insulin work
well.
How are insulin resistance, pre-diabetes, and type 2 diabetes
linked?
If you have insulin resistance, your muscle, fat, and liver
cells do not use insulin properly. The pancreas tries to
keep up with the demand for insulin by producing more. Eventually,
the pancreas cannot keep up with the body's need for insulin,
and excess glucose builds up in the bloodstream. Many people
with insulin resistance have high levels of blood glucose
and high levels of insulin circulating in their blood at
the same time.
People with blood glucose levels that are higher than normal
but not yet in the diabetic range have “pre-diabetes.” Doctors
sometimes call this condition impaired fasting glucose (IFG)
or impaired glucose tolerance (IGT), depending on the test
used to diagnose it. Pre-diabetes is becoming more common
in the United States, according to new estimates provided
by the U.S. Department of Health and Human Services. About
40 percent of U.S. adults ages 40 to 74—or 41 million
people—had pre-diabetes in 2000. New data suggest that
at least 54 million U.S. adults had pre-diabetes in 2002.
If you have pre-diabetes, you have a higher risk of developing
type 2 diabetes, formerly called adult-onset diabetes or
noninsulin-dependent diabetes. Studies have shown that most
people with pre-diabetes go on to develop type 2 diabetes
within 10 years, unless they lose 5 to 7 percent of their
body weight—which is about 10 to 15 pounds for someone
who weighs 200 pounds—by making modest changes in their
diet and level of physical activity. People with pre-diabetes
also have a higher risk of heart disease.
Type 2 diabetes is sometimes defined as the form of diabetes
that develops when the body does not respond properly to
insulin, as opposed to type 1 diabetes, in which the pancreas
makes no insulin at all. At first, the pancreas keeps up
with the added demand by producing more insulin. In time,
however, it loses the ability to secrete enough insulin in
response to meals.
Insulin resistance can also occur in people who have type
1 diabetes, especially if they are overweight.
What causes insulin resistance?
Because insulin resistance tends to run in families, we
know that genes are partly responsible. Excess weight also
contributes to insulin resistance because too much fat interferes
with muscles' ability to use insulin. Lack of exercise further
reduces muscles' ability to use insulin.
Many people with insulin resistance and high blood glucose
have excess weight around the waist, high LDL (bad) blood
cholesterol levels, low HDL (good) cholesterol levels, high
levels of triglycerides (another fat in the blood), and high
blood pressure, all conditions that also put the heart at
risk. This combination of problems is referred to as the
metabolic syndrome, or the insulin resistance syndrome (formerly
called Syndrome X).
===Metabolic Syndrome===
Metabolic syndrome is defined by the National Cholesterol
Education Program as the presence of any three of the following
conditions:
- excess weight around the waist (waist measurement of
more than 40 inches for men and more than 35 inches for
women)
- high levels of triglycerides (150 mg/dL or higher)
- low levels of HDL, or "good," cholesterol (below 40 mg/dL
for men and below 50 mg/dL for women)
- high blood pressure (130/85 mm Hg or higher)
- high fasting blood glucose levels (110 mg/dL or higher)
To read the rest of this article from the National Diabetes
Information Clearinghouse, please click here: http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/
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