Insulin Resistance Care – Background
As a diabetes and weight loss specialist practicing in Rockville, Montgomery County, Maryland, one of my focuses is the holistic approach to diagnosing and managing insulin resistance. I frequently receive questions from my patients about the definition, importance, and therapies for insulin resistance. So, without further ado, let’s explore what insulin resistance entails.
Definition of Insulin Resistance
Insulin resistance is a condition in which the body’s cells become less responsive to the effects of insulin, a hormone produced by the beta cells in the pancreas. Insulin is central for regulating blood sugar (glucose) levels, facilitating the uptake of glucose by cells for energy. When cells develop resistance to insulin, glucose is not efficiently absorbed, leading to elevated blood sugar levels. This, in turn, can result in various medical consequences and complications, as outlined below.
Consequences of Insulin Resistance
- Hyperglycemia: Insulin resistance results in decreased effectiveness of insulin, leading to higher levels of glucose in the bloodstream, causing hyperglycemia (high blood sugar).
- Type 2 Diabetes: Prolonged insulin resistance can progress to type 2 diabetes, a chronic condition characterized by elevated blood glucose levels due to impaired insulin function.
- Metabolic Syndrome: Insulin resistance is a key component of metabolic syndrome, a cluster of conditions that includes abdominal obesity, elevated blood pressure, high blood sugar, and abnormal lipid levels. These factors collectively increase the risk of cardiovascular disease and type 2 diabetes.
- Cardiovascular Disease: Insulin resistance contributes to atherosclerosis (hardening of arteries) and increases the risk of cardiovascular diseases such as coronary artery disease, heart attack, and stroke.
- Hypertension: Insulin resistance is associated with an increased risk of hypertension (high blood pressure), which is a significant risk factor for cardiovascular diseases.
- Dyslipidemia: Insulin resistance can lead to abnormal lipid (fat) metabolism, resulting in elevated triglyceride levels, reduced HDL (good cholesterol), and an increase in small, dense LDL particles, all of which contribute to dyslipidemia.
- NASH (Non-Alcoholic Steatohepatitis): Insulin resistance is a major factor in the development of non-alcoholic fatty liver disease (NAFLD) and its more severe form, NASH, which involves inflammation and damage to the liver.
- Weight Gain and Obesity: Insulin resistance can promote weight gain and obesity by disrupting the regulation of fat storage and metabolism.
- Polycystic Ovary Syndrome (PCOS): Insulin resistance is often associated with PCOS, a common hormonal disorder in women that can lead to irregular periods, ovarian cysts, and fertility issues.
- Hyperuricemia and Gout: Insulin resistance is linked to elevated uric acid levels (hyperuricemia), increasing the risk of gout, a painful inflammatory arthritis caused by the deposition of urate crystals in joints.
- Inflammation: Insulin resistance can lead to an increased production of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). These cytokines play a key role in promoting chronic low-grade inflammation, which can contribute to the development of various diseases, including cardiovascular disease, diabetes, and NASH.
- Cancer: Some studies suggest a link between insulin resistance and an increased risk of certain cancers, such as colon and breast cancers, possibly due to the promotion of cell growth and proliferation.
It is important to note that these complications often interconnect, resulting in a complex network health risks associated with insulin resistance. Lifestyle modifications, including a healthy diet, regular physical activity, and weight management, are essential in managing insulin resistance and reducing its associated complications. Furthermore, medical interventions, such as medications to enhance insulin sensitivity (e.g., GLP-1 agonists like Mounjaro and Ozempic, as well as Metformin), may be prescribed in specific cases.