People from the fields of diabetes, cardiology and public health medicine believe that scientific research on insulin resistance has made some progress in recent years. It was only in this century that insulin resistance and prediabetes began to receive the focus of medical research.
The terms insulin resistance syndrome, metabolic syndrome, and even syndrome X refer to the cluster of risk factors associated with insulin resistance.
In contrast, the classic symptoms of diabetes since the 17th century: polyuria and thirst, have long been known to the general public. More than a century ago, researchers discovered the role of the pancreas and insulin in diabetes again.
Insulin resistance has now been identified as a factor in the development of type 2 diabetes, but the cause of type 2 diabetes is not as simple as that. So what exactly is insulin resistance and how did it develop?
Fast facts about insulin resistance Insulin resistance is a “silent” risk factor that coexists with other risk factors for diabetes and cardiovascular disease, and remains when it is no longer silent but causes elevated blood glucose levels in type 2 diabetics.
This phenomenon is complex, and only recently has research led to a better understanding of the science of diabetes.
There are no signs or symptoms of insulin resistance per se before prediabetes or diabetes develops, and the body’s blood glucose levels can be normal when insulin resistance alone is present. In people who are obese or overweight, have a family history of hypertension or diabetes, insulin resistance becomes a risk factor for diabetes and cardiovascular disease, and becomes part of a “cluster” of other risk factors.
The presence of insulin resistance alone does not require treatment, but the risk of occurrence over 5 and 10 years can be prevented by lifestyle and medical measures.
What is insulin resistance?
It is a risk factor for cardiovascular disease in people with diabetes. Insulin resistance exists before a person with type 2 diabetes is diagnosed, but it is still a part of type 2 diabetes.
There is a relatively new concept in medicine – insulin resistance is a phenomenon that increases the chance of prediabetes, and the body’s increasing blood sugar levels will eventually lead to the development of type 2 diabetes.
Data from the Centers for Disease Control and Prevention (CDC) indicate that about 15-30% of people with prediabetes will develop diabetes within 5 years.
The American Heart Association (AHA) highlights a longer outlook – a 10-year risk. About 50 percent of people with high blood sugar will develop type 2 diabetes in 10 years, they said. But the AHA also notes that this also means that half of those approximately 50 percent of people with high blood sugar will not develop type 2 diabetes – “your choice makes a difference.
Public health experts and specialists present these data to show that any patient with hyperglycemia, insulin resistance, diabetes, obesity or metabolic syndrome can reduce their risk of developing type 2 diabetes in the future by taking a number of precautions.
These preventive measures are lifestyle and medical help that can reduce the risk of developing diabetes and a combination with monitoring. Not only that, but these preventive measures can also reduce some of the potential problems in the development of cardiovascular disease.
How does insulin resistance develop?
Although research has been under development for 10-15 years, why and how insulin resistance develops is not yet clear.
Insulin resistance occurs in people with risk factors, including genetic and lifestyle factors that
May be resistant to the action of insulin Insulin is necessary to regulate the circulation of glucose in the blood – it induces glucose into the cells to be used Insulin is also a chemical messenger that signals the liver to store glucose rather than releasing it into the blood (glucose is stored in the liver in the form of glycogen) Insulin is usually needed to maintain a good balance just enough to meet our energy needs, so that a predictable blood glucose level can be maintained at different times of diet and activity without allowing the level of blood glucose to rise too high for too long.
However, insulin resistance initially causes the pancreas to simply produce more insulin to maintain safe blood glucose levels and prevent the onset of symptoms – this is when the body is only insulin resistant and there is no other disease.
However, insulin resistance eventually progresses to pre-diabetes with persistently high blood glucose levels and then to diabetes with persistently high blood glucose levels; the additional insulin needed to compensate for the increasing insulin resistance cannot be maintained in secretion.
The development and progression of insulin resistance is complex, and the etiology of the development of insulin resistance in particular, but the good thing is that there are now many ideas about preventing insulin resistance. And it is also possible to manage insulin resistance when type 2 diabetes is not prevented from occurring.
Signs of insulin resistance do not show any outward signs of insulin resistance itself if it does not develop into diabetes. Although insulin resistance is as present as other risk factors, patients themselves will not notice any symptoms.
Blood glucose test readings are often used in the diagnosis of pre-diabetes and diabetes, but insulin resistance may only be present in people who are at high risk: insulin resistance alone; asymptomatic, but with risk factors such as obesity; and blood glucose levels that are not elevated – a fasting blood glucose test showing blood glucose below 100 mg/dL (5.6 in mmol/L) is normal. For an A1C (HbA1c) test if the result is less than 5.7%, the average blood glucose level has been normal for the past few weeks.
Pre-diabetes is asymptomatic, but hyperglycemic fasting glucose (5.6-6.9 mmol/L) has elevated blood glucose levels in the range of 100-125 mg/dL or an A1C test of 5.7-6.4%.
Patients often present with certain symptoms before diabetes is diagnosed, including polyuria and thirst Blood glucose levels are high enough to warrant a diagnosis of diabetes and require acceptance and treatment – 126 mg/dL and above, fasting blood glucose (7 mmol/L) or glycated hemoglobin ≥ 6.5%.
The reason insulin resistance does not initially show signs or symptoms is because the body has adapted to it, and the body maintains normal blood glucose levels despite having developed the problem.
When pre-diabetes occurs, insulin resistance is thought to contribute to the increase in blood sugar and is part of pre-diabetes.
In fact, insulin resistance is still an important component of type 2 diabetes and plays a key role in the reduction of insulin secretion by the pancreas.
The most important problem in type 1 diabetes is insufficient insulin secretion. In contrast, the most important problem in type 2 diabetes is the body’s reduced sensitivity to insulin.
Risk factors Some risk factors for diabetes are also risk factors for heart disease and other cardiovascular diseases, such as stroke.
Therefore, in recent years, the fields of heart disease, diabetes and public health have been thinking about a “set of risk factors” for diabetes and heart disease.
Because some of these factors can be avoided and because obesity has become a particularly widespread problem, there is a growing interest in lifestyles that can help us reduce our chances of developing disease.
The following are risk factors for insulin resistance, prediabetes and diabetes, and some of them can be changed with lifestyle changes or medical help.
Overweight and obesitySedentary lifestyleHigh blood pressureHigh cholesterolFamily history of diabetesAfrican American, Asian American, Hispanic, Indian and Pacific Islander backgroundPeople with a history of gestational diabetes or who deliver babies weighing more than 9 pounds (4 kg).
The U.S. Department of Health and Human Services recommends that all people who are overweight and older than 45 years of age should have their blood glucose levels tested to determine if they have pre-diabetes or diabetes.
Other people who are overweight but younger than 45 should also be tested if they have one or more of the other risk factors listed above, while a sedentary lifestyle is not considered a risk factor for testing for diabetes.
Prevention of Insulin Resistance and Type 2 Diabetes Although not all risk factors for insulin resistance and type 2 diabetes are modifiable, such as family history and genetic factors, there are measures that have been clearly shown to reduce the incidence of insulin resistance and type 2 diabetes. Obesity is a specific risk factor.
Some factors may also be key factors in preventing heart disease and stroke.
In summary, lifestyle changes can help prevent the development of insulin resistance and diabetes, or slow the progression of these diseases, with a wide range of health benefits.
On the idea of preventing diabetes, the AHA simply says, “Lose weight and get moving.”
When type 2 diabetes is diagnosed, some of its potential complications are also preventable and manageable.