If you are not diabetic, you may have heard of insulin but perhaps are a little unclear on what it is or what it does. Simply put, insulin is a hormone made by the pancreas. Within the digestion process, insulin allows the body to use glucose – the type of sugar found in many carbs – for energy. Insulin can be thought of as a lever, as it also helps your body balance blood glucose levels. If there is too much glucose in your blood, insulin signals the body to store the excess in your liver. If there is too little, insulin signals the body to release glucose when your body needs energy, which could be between meals, during exercise or if you are stressed.
Insulin resistance is a reduced sensitivity of body tissue to insulin, mainly by muscle, the liver and fat tissue. This reduced sensitivity means that the body’s cells cannot use glucose effectively as energy, often leading to high blood sugar levels. As a response, the pancreas then produces more and more insulin until it is exhausted and ultimately fails.
Now that we’ve covered that, you’re probably asking “What’s the relevance to me?” Insulin resistance is a key factor in the development of type 2 diabetes, gestational diabetes (during pregnancy), and pre-diabetes. And it matters because more and more people are becoming diabetic without realizing it. In the UAE, 20 percent of the UAE population has diabetes and another 20 percent are pre-diabetic. The World Health Organization estimates that 50 percent of adult diabetes is undiagnosed. The overwhelming majority of diabetics, around 95 percent, suffer from type 2.
As well as type 2 diabetes, insulin resistance can also lead to high blood pressure, cardiovascular diseases, lipid metabolism disorders and obesity. Since insulin resistance is the main factor and common denominator of so many conditions, it’s important to know the root causes and risk factors for this prevalent condition.
With the current medical information, we have, it is assumed insulin resistance can slowly develop and progressively get worse over the course of years and even decades. So, what causes it to develop? Insulin resistance can be caused by genetic predisposition or lifestyle factors, or a combination of the two. Let’s take a closer look:
Genetic Predisposition: Numerous scientific studies have shown that insulin resistance and type 2 diabetes are to a large extent, hereditary. But lifestyle factors can accelerate it or slow it down or make it possible to avoid it.
Lifestyle factors: Staying physically active and eating a diet of fresh, unrefined ‘whole’ foods with plenty of vegetables is a key factor in preventing insulin resistance. On the other hand, a sedentary lifestyle and a diet filled with processed high fat, high sugar foods can put you at greater risk.
High BMI: Maintaining a healthy Body Mass Index score is very important. If your Body Mass Index indicates that you are overweight or obese, you are a higher risk. Fat cells change both their size and their function with increasing obesity and with this in mind, the effects of insulin can be weakened by the release of various substances from the fat cells. Approximately 80 percent of all newly diagnosed type 2 diabetics are overweight.
Other Causes: Other factors that can lead to insulin resistance include hormonal changes like pregnancy, polycystic ovary syndrome, menopause; short-term infectious diseases, or acutely stressful situations. While many of these factors fall outside of one’s control, maintaining a healthy lifestyle with a lot of physical activity and good ‘whole food’ nutrition can reduce the chance of any of the factors leading to insulin resistance.
If you suspect that you may have insulin resistance, a simple, if not absolutely reliable, clue is the presence of various factors and symptoms that often appear in metabolic syndromes such as obesity, high cholesterol and high blood pressure. The risk increases further if type 2 diabetes is present in a parent or sibling. With the help of certain blood tests, a doctor can also get an indication of whether there is insulin resistance.
If you’ve already developed insulin resistance, the good news is that it doesn’t always lead to diabetes and the condition can be significantly improved or even reversed depending on the individual. Recent studies have shown that lifestyle changes that include increased physical activity and weight loss will lead to a substantial improvement.
Dr Yousef Said is a specialist in Internal Medicine & Diabetology at GluCare Integrated Diabetes Center, the made-in-the-UAE clinic and the first in the world clinic to empower patients through remote continuous data monitoring. GluCare is also an early adopter of Digital Therapeutics software and the first clinic in the region to use it, combined with wearable and smart technology, artificial intelligence, unique in-clinic workflows and a caring and connected expert care team. He is sharing his knowledge on insulin resistance and why it matters to everyone ahead of World Diabetes Day on November 14.