Insulin resistance (insulin sensitivity) – Causes, symptoms and treatment

Insulin resistance means the body’s decreased sensitivity to insulin, the hormone responsible for regulating blood sugar levels. Insulin resistance can lead to the development of type 2 diabetes or other diseases. This is especially true for people who are overweight and obese, who are at the highest risk of developing insulin resistance.

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What is insulin resistance?
Insulin resistance is not a separate disease, but it is part of the so-called metabolic syndrome, which are groups of disorders that often occur together in one person and are closely related. These include obesity, hypertension , disturbances in triglyceride and cholesterol metabolism, and fasting blood glucose.

Reasons and risk factors of insulin resistance
Insulin resistance can be genetic, for example, when the body produces a hormone that is abnormally structured (called mutant insulin syndrome). Decreased insulin sensitivity can also be the result of an excess of anti-insulin hormones, such as:
• cortisol (Cushing’s syndrome)
• glucagon
• growth hormone (acromegaly)
• thyroid hormones ( hyperthyroidism )
• parathyroid hormone (primary hyperparathyroidism)
• androgens

However, people who are overweight and obese have the greatest risk of developing insulin resistance, because adipose tissue makes their bodies most resistant to insulin.

Adipose tissue contributes to the development of insulin resistance by producing hormonal substances that have an effect opposite to insulin or inhibit its effects, and by direct secretion into the blood, the so-called free fatty acids (PUFA).

With an excess of free fatty acids (PUFA), the body begins to use them as an energy source instead of glucose. As a consequence, glucose is not burned in the tissues and its level in the blood rises. Then the body, in order to maintain the proper level of sugar in the blood, increases the secretion of insulin.

Other risk factors are:
• age (the risk of developing the disease increases with age)
• gender (men are more often diagnosed with abdominal obesity, which is a high risk factor for developing insulin sensitivity)
• low physical activity
• high calorie diet
• use of diabetogenic drugs ( glucocorticosteroids, thiazide diuretics, HIV protease inhibitors, birth control pills, loop diuretics, calcium channel blockers)
• alcohol
• smoking

Symptoms of insulin resistance
Insulin resistance can be latent or manifested in various ways, for example by:
• carbohydrate metabolism disorders
• elevated blood cholesterol levels
• higher levels of triglycerides in the blood above the norm
• android-type obesity
• hypertension
• increased levels of uric acid in the blood

Diagnosis of insufficient resistance
Isulinoprotection can be diagnosed in several ways:
• oral glucose load test
The test consists of administering glucose to the patient and observing his body’s response to it: insulin secretion, the rate of regulation of blood sugar levels, the rate of glucose absorption into the tissues.
• HOMA method (Homeostatic Model Assessment)
Blood is taken from the patient and the concentration of glucose and insulin is determined. Then
, on this basis, using the appropriate formula, the so-called insulin resistance index (HOMA-IR).
• metabolic clamp method – determining the GIR parameter, ie the rate of glucose infusion

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Author: DoctorMaryam.org

4th Professional Medical Student. Karachi Medical and Dental College.

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