If there’s one thing you can count on, it’s change.
Indeed, things don’t stay the same forever, including our bodies. A common result of our bodies changing is an increased level of insulin resistance. This happens for all kinds of reasons — we’ll get into those reasons later — but insulin resistance is when your muscle, fat and liver cells struggle to absorb glucose from your blood. When this happens, your pancreas makes more insulin to compensate.
Insulin resistance isn’t quite the same as diabetes, but there’s a lot of overlap. Mark Bridenstine, MD, an endocrinologist at Banner Health Clinic in Loveland, CO, talked to us about insulin resistance: who’s most at risk, how to reduce it and its relationship to diabetes.
Who’s at risk?
Although there is a specific medical test to determine insulin resistance, it is fairly complicated and is typically used only for research purposes. Instead, physicians will most often diagnose insulin resistance by seeing if the patient shows some related risk factors. According to the National Institutes of Health (NIH) some of those factors include:
- Overweight or obesity
- Age (45 or older)
- A parent, brother or sister with diabetes
- African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian or Pacific Islander American ethnicity
- Physical inactivity
- Health conditions such as high blood pressure and abnormal cholesterol levels
- A history of gestational diabetes
- A history of heart disease or stroke
- Polycystic ovary syndrome (PCOS)
- Certain medicines, such as glucocorticoids, some antipsychotics, and some medicines for HIV
- Hormonal disorders, such as Cushing’s syndrome and acromegaly
- Sleep problems, especially sleep apnea
If the patient answers “yes” to some of these criteria, there’s a chance they’re also insulin resistant. Dr. Bridenstine said that at his practice, obesity and a family history of diabetes are among the most common risk factors here.
Experts have pointed to obesity — particularly fat in the abdomen and around the organs, called visceral fat — as a main cause of insulin resistance. A waist measurement of 40 inches or more for men, and 35 inches or more for women, can indicate some level of insulin resistance, regardless of BMI level.
The American Diabetes Association points out that insulin resistance alone may not have any symptoms at first, but over time it will get worse, and the pancreas’s cells that make insulin can eventually wear out. This results in higher blood sugar levels, and can become prediabetes or type 2 diabetes.
Insulin resistance and diabetes
Not everyone with diabetes is insulin resistant, and not everyone with insulin resistance will get diabetes. Dr. Bridenstine explained that insulin resistance is a broader term: If your body is secreting higher levels of insulin to adequately regulate your blood glucose, then you have insulin resistance.
With type 1 diabetes, the central issue is insulin deficiency: The pancreas’s cells that normally produce insulin just aren’t doing it. Type 2 diabetes, meanwhile, is about the body resisting the insulin it has already made. Both of these groups can experience insulin resistance.
For folks with diabetes, Dr. Bridenstine said there are usually more factors impacting their insulin resistance than they might realize — “And it changes!” he added. “Year to year, month to month, even day to day.” Things like food, activity levels, stress, medications, medical conditions and sleep quality all play a part.
Combatting insulin resistance
According to the American Diabetes Association, exercise is the best way to combat insulin resistance. Why? Because it makes the body more sensitive to insulin and builds muscle that can absorb the blood glucose. As for what type of exercise, both aerobic and resistance exercise are effective. In insulin-resistant adults who are frail and obese, combining exercise with weight loss has proven to be a crucial combo.
Both severe sleep loss and moderate short-term sleep loss can negatively impact your insulin resistance, too. And studies indicate that certain diets, such as the Mediterranean diet, are associated with improved insulin sensitivity.
Exercise, diet, weight loss and sleep — those are the big four when it comes to treating insulin resistance. Dr. Bridenstine also mentioned the importance of blood sugar monitoring (A1c tests, using continuous glucose monitors, etc.).
“Knowledge is power,” he explained, “and when you know yourself and how your body reacts to situations, it sets you up to make healthier, more informed decisions over time.”
Getting help when you need it
Our bodies change — sometimes temporarily, sometimes permanently — and those changes mean our bodies may react differently to food, exercise, etc. than they used to.
“Basically, the same plan that may have worked for a long time either needs to be tweaked or completely reinvented,” Dr. Bridenstine said. Changing habits and routines can be hard. But adapting to change is absolutely possible, and when it comes to insulin resistance, it’s usually crucial.
To find a specialist near you, visit bannerhealth.com. You may also be interested in some of these related articles, written with help from Banner Health experts: