What is insulin resistance?

1. How does insulin resistance develop?
2. What increases the risk of insulin resistance?
3. How does insulin resistance manifest itself and how is it diagnosed?
4. What can be done to prevent insulin resistance?
5. What are the health risks associated with insulin resistance?
6. Why does insulin resistance cause type 2 diabetes?
7. How is insulin resistance treated and can it be cured?

Insulin resistance itself does not cause any symptoms and therefore remains undiscovered for a long time. The reduced sensitivity to insulin often becomes noticeable when complications have already developed, or elevated blood sugar has been repeatedly diagnosed. Years or even decades can pass before elevated blood sugar levels develop as a result of insulin resistance  During this time, those affected often don’t notice any change to their sugar metabolism.

Certain characteristics can indicate insulin resistance. However, their presence doesn't always mean that there is insulin resistance. These characteristics include:

• Elevated Triglycerides values in your blood
• Reduced HDL cholesterol values in your blood
• High blood pressure
• Abdominal obesity (too much stomach fat)
• Elevated blood sugar levels
• Type 2 diabetes in the family (parents or siblings)

The more that these characteristics are present, the more likely insulin resistance is.

A simple process to determine insulin resistance is calculation of the HOMA index (HOMA = homeostasis model assessment). The fasting insulin levels and fasting glucose levels (using the unit mmol/l) are measured and multiplied by one another.  When the HOMA index value exceeds a certain level, it can be assumed that insulin resistance is likely. The HOMA index is especially suited to determining the early and middle phases of insulin resistance. When the insulin-producing cells in the pancreas are already exhausted, the HOMA index no longer has any indicative value for insulin resistance.

An elevated level of intact proinsulin in blood also points to insulin resistance. Proinsulin is a precursor of insulin. Proinsulin is normal fully converted into insulin meaning that only minute amounts of proinsulin can be detected in the blood. When the pancreas increases insulin production due to insulin resistance, this can result in proinsulin not being fully converted into insulin and being detectable in higher levels in blood.

Determination of the effects of insulin is very complex and is usually only carried out at specialized diabetes centers - and normally only during studies. The clamp technique is used. Using this technique, a defined amount of insulin and variable amount of glucose is administered directly into a venous blood vessel via a port until a normal blood sugar level has been achieved. The greater the amount of glucose that can be administered together with a fixed amount of insulin, the more effective the insulin and the lower the insulin resistance.

Insulin resistance is promoted by certain lifestyle habits. The good news: Making changes to your lifestyle habits can help improve the insulin resistance of the body’s cell. This helps prevent the onset of insulin resistance or the reduction of preexisting insulin resistance. Effective measures include regular physical activity, weight loss if overweight (especially if there is too much abdominal fat) and a corresponding adjustment of dietary habits.

Insulin resistance is often accompanied by high blood pressure, fat metabolism disorders, obesity, and elevated blood sugar levels – experts call this a metabolic syndrome.

Insulin resistance is not only a significant cause of type 2 diabetes: the reduced sensitivity of the body’s cells to the hormone insulin can also promote high blood pressure and premature damage to blood vessels. The possible long-term complications include nerve damage, kidney damage, heart attack, and stroke. This makes it all the more important to detect insulin resistance early and take steps to combat it.

Insulin resistance is one of the major causes of type 2 diabetes. In most cases, it exists for years or decades before type 2 diabetes is diagnosed.

Insulin resistance is when the reaction of the body’s cells to the signal from the hormone insulin is reduced. This results in the pancreas increasing insulin production. The reduced effect of insulin can then be counterbalanced for a time. However, the body then requires ever-increasing amounts of insulin to achieve an effect comparable to that of people with a healthy metabolism. At a certain point, the pancreas will reach the limit of its capacity and will no longer be able to produce enough insulin.

When the effect of insulin is reduced or less insulin is being produced by the pancreas, this is known as a relative insulin deficiency. For example, this results in less of sugar (e.g., from food) entering the cells to act as an energy source. Instead, the sugar (glucose) remains in the blood and the blood sugar level increases. Initially, blood sugar levels are only elevated after consuming food, but later this becomes a permanent state: This is type 2 diabetes.