What is Insulin Resistance?

Harlee Palmer, PA-C

By: Harlee Palmer, PA-C

Insulin resistance is a growing health concern, often preceding type 2 diabetes, heart disease, and metabolic syndrome.

As the body’s cells become less responsive to insulin, a hormone responsible for regulating blood sugar levels, glucose builds up in the bloodstream. This leads to a range of metabolic issues that can have long-term health consequences. By some counts, over 80% of our population has some degree of insulin resistance. Early detection and lifestyle changes can sometimes mitigate these risks and even reverse insulin resistance.

Insulin is a hormone produced by the pancreas that allows cells to absorb glucose from the blood, converting it into energy.

In insulin resistance, the body’s cells become less responsive to insulin, requiring more of the hormone to process glucose. Over time, this can lead to elevated insulin and blood sugar levels, stressing the pancreas and eventually leading to conditions such as prediabetes or type 2 diabetes. Chronically elevated insulin levels cause insulin resistance.

Causes of Insulin Resistance

There are several causes of insulin resistance, and most people will have more than one.

1. Genetic Factors: A family history of type 2 diabetes or insulin resistance increases the likelihood of developing the condition.
2. Obesity: Excess fat, especially around the abdomen (visceral fat), is closely linked with insulin resistance. Adipose tissue produces inflammatory substances that impair insulin sensitivity.
3. Physical Inactivity: Lack of regular exercise leads to less efficient glucose metabolism, making cells more resistant to insulin over time.
4. Diet High in Sugars and Processed Foods: A diet rich in refined carbohydrates and sugars causes frequent spikes in blood sugar and insulin, eventually reducing the body’s sensitivity to insulin.
5. Hormonal Imbalances: Conditions like polycystic ovary syndrome (PCOS) or Cushing’s syndrome are linked to insulin resistance.
6. Chronic Stress: Prolonged stress increases cortisol levels, affecting insulin sensitivity and promoting fat storage, particularly around the abdomen.

Common signs of insulin resistance include:

1. Acanthosis Nigricans: Dark, thick, and velvety patches of skin, typically found on the neck, armpits, groin, or under the breasts.

2. Frequent Hunger and Cravings: Feeling hungry shortly after eating, especially craving sugary or carbohydrate-rich foods.

3. Fatigue: Constant tiredness or low energy, even after adequate rest, because your cells aren’t efficiently absorbing glucose for energy.

4. Weight Gain, Particularly Around the Abdomen: Difficulty losing weight, with fat accumulating, especially around the waist and abdominal area (visceral fat).

5. High Blood Sugar Levels: Blood sugar levels that are consistently higher than normal but not yet in the diabetes range (prediabetes).

6. High Blood Pressure: Insulin resistance is associated with elevated blood pressure, which can increase the risk of heart disease.

7. Increased Triglycerides and Low HDL Cholesterol: Elevated levels of triglycerides (a type of fat found in the blood) and lower levels of HDL (“good”) cholesterol.

8. Skin Tags: Small, soft skin growths, often found in areas where the skin folds, like the neck, armpits, or groin.

9. Difficulty Concentrating or Brain Fog: Problems with focus, memory, or mental clarity, as glucose imbalances affect brain function.

10. Polycystic Ovary Syndrome (PCOS): In women, insulin resistance is often linked with PCOS, which includes symptoms like irregular periods, excess hair growth, and fertility issues.

11. Increased Waist Circumference: A waist measurement of over 40 inches for men and 35 inches for women is a key indicator of insulin resistance.

Numbers to know:

• Fasting Insulin: Less than 6 is optimal
• A1c: This is a 3 month average of your blood glucose. Levels above 5.6 indicate prediabetes
• Triglyceride to HDL ratio: Less than 1.5 is optimal.

Lifestyle factors largely influence insulin resistance, making it manageable and often reversible with the right changes. Key strategies include:

1. Dietary Changes: A diet rich in whole foods, fiber, lean proteins, healthy fats, and low in refined sugars and processed carbohydrates can improve insulin sensitivity. Foods like vegetables, whole grains, legumes, and nuts should be prioritized.
2. Regular Physical Activity: Exercise helps cells become more sensitive to insulin. Both aerobic activities (e.g., walking, running, cycling) and strength training improve insulin function.
3. Weight Management: Losing excess weight, especially visceral fat, can significantly enhance insulin sensitivity.
4. Stress Reduction: Chronic stress negatively impacts insulin sensitivity. Meditation, deep breathing, and yoga can help lower cortisol levels.
5. Adequate Sleep: Poor sleep quality or duration increases insulin resistance. Prioritizing 7-9 hours of sleep per night can help regulate blood sugar and insulin levels.