Insulin Resistance

This is information assembled from the ADA website, and a number of other sources, written as I understand it. Cross reference and double check the accuracy of what I am presenting.

Insulin resistance is USUALLY, but not always associated with obesity. The connection is so strong that you can say with fairly high accuracy that if you have extra weight around your middle, then you have some degree of insulin resistance. Whether or not it is significant or will develop into something serious though will vary from person to person, and the only way to know is to test.

Insulin resistance occurs when the body does produce enough insulin, but the cells do not use it well, so blood sugar levels are higher than normal at times even though there is enough insulin. Insulin resistance is usually accompanied by abnormally high insulin levels in early phases.

This condition can cause slow pancreatic damage, and slow deterioration to other organs over the long term. The progress is very slow, but most of the damage it does is not reversible - it won't heal when the cause is removed. So catching it early and dealing with it is important.

Losing weight improves this condition in most people. Gestational diabetes also has a strong insulin resistance factor, which cannot be controlled by weight loss though, because of the need to maintain or gain during pregnancy.

There are medications that can help the body to utilize insulin better. Insulin injections are sometimes used for people with insulin resistance, but it is not the preferred strategy because the body is usually producing enough insulin, it is simply not being used well. Adding more insulin is not the most productive way to approach the condition.

There are many conditions which can have an effect on insulin resistance. Many of the interactions between autoimmune disorders and other complex systemic disorders, and insulin resistance are not fully understood. It is known that insulin resistance often accompanies various syndromes with heart disease, high blood pressure, high cholesterol, obesity, and kidney disease. The cause and effect of these interactions is also not fully understood at this point. Insulin resistance is also associated with infertility, and not just with PCOS. The spikes in blood sugar that result from poor insulin utilization can cause a fertilized egg to fail to implant properly, resulting in a pregnancy loss that is so early that it just appears to be a late period.

Excess weight, especially in the middle of the body - often a fat pad just above the navel - is one of the strongest predictive factors for insulin resistance. It is so prevalent in the US, due to high sugar and refined grains in the diet, that an estimated 1/3 or more of the population is predicted to be either already diagnosed with Type II diabetes, or well into the progression to developing it. Watching people around me persuades me that this estimation is NOT exaggerated - if anything, it is far short of the reality.

Control of carbohydrate intake, and a change to good carbs instead of bad ones is the primary strategy for addressing insulin resistance in any situation, including pregnancy. This change alone is sufficient to effect a radical change in most people with this condition. For some, it will continue to progress anyway, often due to other metabolic or systemic factors. Even for them though, diet makes a huge difference in how fast it progresses, and may eliminate the development of many of the serious problems associated with high blood sugar.

Since there is such a strong tie between weight and insulin resistance, a doctor may assume that it is the sole factor in blood sugar control in an overweight patient. Unfortunately, some conditions predispose an individual to obesity, and also to pancreatic deterioration, and those patients may need to insist on further testing or treatment if they are given prescriptions that do not work. Because of this, it is important that if your doctor prescribes medication for insulin resistance, you should know your blood sugar numbers before you start the medication, and then track them after you start it. If it does not work within 1-2 months, then it is wise to request a change in medication, or additional testing to verify pancreatic function. Your doctor will not know that it is not working if you do not monitor it, and it is your responsibility to report accurately to your physician, and work with them to achieve an effective treatment.

Written by Laura Wheeler, Owner of Firelight Business Enterprises, Inc.