When I was diagnosed with polycystic ovarian syndrome [1] (PCOS), I did a ton of research on the condition and found that insulin resistance is common among women who have PCOS. Although I knew that insulin resistance was related to elevated blood sugar levels and could lead to type 2 diabetes, I wasn't exactly sure what insulin resistance meant. Were there any symptoms? How can I get it under control? What were the potential health complications?
Luckily, I tapped a few experts to weight in on what exactly insulin resistance is and how it can be treated. The good news: an insulin resistance diagnosis doesn't have to foretell diabetes or other chronic disease.
Insulin is a hormone secreted by the pancreas to help digest carbohydrates to glucose, so that your cells can absorb glucose to use as energy. It plays a key role in metabolism and blood sugar regulation [2].
"In insulin resistance, cells and muscles stop absorbing glucose as efficiently and more glucose stays in the blood," explained Rebecca Elbaum, RD, CDE. "The body then needs more insulin to absorb glucose so that it can be delivered to the cells. Eventually, the cells that secrete insulin fail to keep up with the body's need and blood glucose builds up in the blood stream and stays elevated."
This elevated blood sugar can lead to chronic disease and other serious complications such as prediabetes and full-blown type 2 diabetes.
And while people who have insulin resistance aren't necessarily more prone to gaining weight, being overweight or obese can cause insulin resistance explained Kathleen Wyne, MD, endocrinologist at The Ohio State University Wexner Medical centre. "Most people who are obese are insulin resistance," she said.
Other than the likelihood of having insulin resistance from being overweight or obese, the only other physical symptom is acanthosis nigricans, or a dark colouring of the skin on the neck or armpit. If you think you may be at risk for insulin resistance, be sure to visit your doctor; the diagnostic criteria includes being overweight or obese (with a concentration of belly fat), having a fasting blood glucose level between 100 and 125 mg/dl, hypertension, triglyceride levels of over 150, and low HDL ("good" cholesterol) at less than 40 for men and less than 50 for women, explained Wyne.
Fortunately, treating insulin resistance is pretty straightforward, if not always easy: weight loss [3], regular exercise, and possibly the medication Metformin to lower blood sugar.
"The best way to reverse [insulin resistance], if it's caught early enough, is through lifestyle modifications [5]," said Eduardo Grunvald, MD, program director at UC San Diego's Weight Management Program. "So just exercise, independent of weight loss, just regular exercise will improve insulin sensitivity."
In addition to working out, losing weight will improve insulin resistance — losing just 15 pounds and keeping it off will slow the progression to diabetes says Dr. Wyne.