Insulin Resistance

Insulin Resistance General Information

Insulin Resistance is the generic medical term given to the condition when regular quantities of insulin are insufficient to obtain the normal response from the organism – this effect is seen with both endogenous insulin (produced within the body) and exogenous (injected) insulin. In such cases, higher levels of insulin are needed in order to obtain the normal effects. In the initial stages of the affection, the supplementary insulin is produced by the pancreas; however the pancreas can only supply an increased amount of insulin for a limited period of time, and eventually the quantity produced will drop under the quantity required. At this point, the patient will require supplementary insulin in order to ensure the proper functioning of the organism.

Insulin Resistance causes several disturbances in the normal functioning of the organism. Fat cells suffer an increased effect in the hydrolysis of the stored triglycerides, raising the fatty acid levels in blood plasma; in liver cells, the resistance results in a lowered capacity of storing glycogen leading to impossibility to release sufficient quantities of this substance in the blood when the level of blood insulin falls; in muscle cells the resistance causes a reduction in the uptake of glucose which, together with the effect on liver cells, will cause higher levels of glucose in blood. In turn, high levels of insulin and glucose in blood often lead to the appearance of the type 2 form of diabetes and of the metabolic syndrome, together with all the complications that may appear.

Insulin Resistance Symptoms

Typically, Insulin Resistance does not cause any obvious symptoms in the patient. The condition may be present for several years before being detected. However, in some cases this condition is known to produce some signs that initially may be mistaken for symptoms of another disease; a blood test may reveal a high level of blood glucose, while at the same time the insulin levels are also increased, which will allow the examining health care specialist to place the correct diagnosis.

Not all cases of Insulin Resistance are though symptomatic. When symptoms are present, the patient may experience dizziness and inability to focus, usually accompanied by fatigue, which may be present either as physical or mental fatigue. Mood swings, agitation, headache and nausea are also common in patients that present symptoms of this affection. Low blood sugar is also sometimes an indicator of the condition – although periods of low blood sugar are rather common during the day, they are brief and are generally caused by an irregular eating schedule; prolonged hypoglycemia however is a sign of clinical disorder, especially when it is accompanied by other of the symptoms listed here. Typically, these symptoms are rapidly relieved once the patient consumes a meal.

Other symptoms that may appear in correlation with Insulin Resistance are sleepiness, especially after carbohydrate-rich meals, bloating, weight gain and difficulty in losing weight, increased blood pressure and triglyceride levels and, as a psychological symptom, depression. In severe cases, acanthosis nigricans may set in, and the patient may experience a darkening of the skin on the neck, armpits, knuckles, elbows and knees under the form of rings and / or patches of darker-colored skin.

Insulin Resistance Treatment

Treatment for patients affected by Insulin Resistance can be accomplished by combining the two methods of increasing the cell sensitivity to the actions of insulin as well as decreasing the need for additional insulin. While medication exists for both types of therapy, the largest component of the treatment consists in establishing and following a healthy diet as well as exercising.

The dietary component of the Insulin Resistance treatment aims at reducing the quantity of carbohydrates that the patient ingests. The organism absorbs the carbohydrates by breaking them into their basic components, namely sugars. A particular class of carbohydrates, with a high glycemic index, is especially considered to be harmful to the organism in this condition, as they are more rapidly absorbed in the system and thus create a need for additional insulin quantities to be secreted. Such carbohydrates with a high glycemic index are potatoes, unrefined corn-based products, white breads and unrefined sugars. On the contrary, foods rich in fiber such as brown rice or whole grain breads or foods with low starch content are recommended, such as fruit and vegetables – however it is important to note that the overall glycemic index of the entire meal is taken into account when considering the options from a nutritional point of view.

The low glycemic index diet should be supplemented by a program of physical exercise, as physical effort helps increase the rate at which blood glucose is absorbed by the muscle cells. Drug therapy for patients suffering from Insulin Resistance typically consists of medications that are designed for use in cases of type 2 diabetes – there are no dedicated drugs for this condition, however the current medication for type 2 diabetes has the effect required in this medical condition as well. Metformin is generally the medicine of choice prescribed in Insulin Resistance drug therapy, as it not only acts as an inhibitor, preventing the release of glycogen in the blood at liver cell level, but it also increases the muscle and fat cell sensitivity to insulin and thus helping lower the blood glucose levels. Furthermore, this medicine is generally well tolerated by most patients’ organisms, and although side effects have been associated with Metformin treatment, these are rare.

Another drug which has been used with great results in treating this affection is acarbose, and it acts by slowing the digestion and absorption of sugars thus reducing the need for additional insulin after meals. Medication treatment in cases of Insulin Resistance also may include thiazolidinedione class drugs, such as rosiglitazone or pioglitazone, which also have the effect of increasing insulin sensitivity in the patient’s organism. However, this type of drugs has a high liver toxicity, so in case the patient undergoes treatment with such drugs close monitoring of the liver functions by performing regular blood liver tests is highly advised.

Also controversial but with seemingly high rate of success is the use of vanadium and chromium based compounds in treating this medical condition. However, at this time there are no clear results as tests are still being performed to establish the effectiveness of such drugs in treating this affection.