How can you know if your body is resisting the insulin it’s producing?

Aug 19, 2018 Dr Zulfikar Bux, Features / Columnists, News

By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
Diabetes is very prevalent in Guyana. Persons often think that it has to do with not having insulin in their body. While that is partially true, insulin resistance is the main reason behind many diabetes cases. There are instances where this can be avoided and today we will try to highlight some of them.
WHAT IS INSULIN RESISTANCE?
Insulin resistance is a condition linked to pre-diabetes and type 2 diabetes. Insulin resistance means your body is unable to respond to the amount of the hormone insulin it is producing. Insulin is made by your pancreas, one of your body’s organs. It helps protect your body from getting too much sugar (glucose). Glucose gives you energy. However, too much sugar is harmful to your health.
SYMPTOMS OF INSULIN RESISTANCE
Most people don’t realize they have insulin resistance until they have a blood test. Everyone has high blood sugar levels from time to time. However, when your body’s sugar level is consistently high, you may notice you are more thirsty, urinate more, are more tired, have blurred vision, and have some tingling on the bottom of your feet.
WHAT CAUSES INSULIN RESISTANCE?
Obesity (being significantly overweight and belly fat), an inactive lifestyle, and a diet high in carbohydrates are the primary causes of insulin resistance. Some women develop insulin resistance while they are pregnant. This is called gestational diabetes. Certain diseases are associated with insulin resistance. That includes heart disease, nonalcoholic fatty liver disease, and polycystic ovary syndrome.
Certain risk factors are associated with insulin resistance, including:
• A family history of diabetes.
• A sedentary (not active) lifestyle.
• Race (especially if you are of Indian or African descent).
• Age (the older you get, the more your risk increases).
• Hormones.
• Steroid use.
• Some medicines.
• Poor sleep habits.
• Smoking.
HOW IS INSULIN RESISTANCE DIAGNOSED?
During a doctor visit, your doctor will ask you questions about your symptoms, your personal and family medical history, evaluate your weight, and take your blood pressure. Diagnosing insulin resistance requires a blood test. This might be done through a small finger prick or by having a small needle inserted into a vein to take a sample of blood. It is usually called the fasting blood sugar. Your doctor also may have the lab test your cholesterol levels (from the same blood sample). People with insulin resistance often have high cholesterol.
CAN INSULIN RESISTANCE BE PREVENTED OR AVOIDED?
You cannot prevent or avoid risk factors, such as race, age, and a family medical history. You can take steps to reduce your insulin resistance by losing weight (even 10% can make a difference), exercising regularly, and eating a healthy diet. Choose healthy carbohydrates. For example, eat whole grain bread instead of white bread, drink water instead of soda, and reduce your intake of sugary foods.
If you have or have had gestational diabetes, insulin resistance typically goes away after you give birth. However, you are at greater risk of being diagnosed with type 2 diabetes when you are older. That should be a warning to change your diet and lifestyle early so that you can delay it for as long as possible.

HOW CAN INSULIN RESISTANCE BE TREATED?
Diet, weight loss, and exercise can improve insulin resistance. However, most people need medicine, as well. Your doctor will prescribe a medicine that works best for your health and lifestyle needs. If your insulin resistance leads to uncontrolled type 2 diabetes, you may need insulin (given through a pump or daily injection).
Living with insulin resistance requires lifestyle changes, as well regular use of prescription medicine. You will have to be more careful in making meal and snack choices, reading labels, and maintaining a lower weight. You also will have to commit to regular exercise and take your medicines as prescribed.

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