How it works
After eating, glucose levels rise and the pancreas releases insulin, which causes cells to take glucose from the blood and the liver to stop producing it. With insulin resistance, the cellular response is weakened, and the gland compensates for this with more hormone. Hyperinsulinemia occurs: sugar is still normal, but insulin is high. Excess insulin in itself is not harmless - it promotes fat accumulation, sodium retention and increased blood pressure, and in women it stimulates the production of androgens in the ovaries. Over time, beta cells become depleted and sugar levels begin to rise.
- Cells respond less well to insulin
- The pancreas secretes more hormones
- Sugar remains normal for some time
- Excess insulin contributes to weight gain and increased blood pressure
- Depletion of beta cells leads to prediabetes and diabetes
Signs and associated conditions
There are no specific symptoms, and most people find out about the problem through tests. Indirect signs are weight gain mainly in the abdominal area, cravings for sweets, drowsiness after eating, difficulty losing weight with normal efforts. A fairly characteristic external sign is acanthosis nigricans: darkened, velvety-to-the-touch areas of skin on the back of the neck, armpits and groin, as well as multiple soft skin growths. In women, insulin resistance often accompanies polycystic ovary syndrome with irregular cycles, acne and excess hair growth.
- Waist circumference is more than 80 cm in women and 94 cm in men
- Acanthosis nigricans - dark areas in the folds of the skin
- Drowsiness and heaviness after eating
- Difficulty losing weight
- Polycystic ovary syndrome
- Fatty liver disease
- High blood pressure and lipid metabolism disorders
What tests are needed
The most commonly used calculation index is HOMA-IR: blood is taken for glucose and insulin in the morning on an empty stomach, after 8–14 hours without food, and the doctor calculates the indicator. It is important to understand the limitations of the method: the index reflects the condition approximately, depends on the laboratory, and is not suitable for people already receiving insulin. Isolated elevated HOMA-IR without taking into account weight, blood pressure, lipids and glucose is not a reason for drug treatment. Therefore, the examination is always broader: they look at glycated hemoglobin, lipid spectrum, liver parameters, and, if necessary, hormones.
- Fasting glucose and insulin with HOMA-IR calculation
- Glycated hemoglobin
- Glucose tolerance test according to indications
- Lipid spectrum
- C-peptide with an unclear picture
- Liver parameters and liver ultrasound
- Waist circumference and blood pressure measurement
What does this threaten?
Insulin resistance is a central component of metabolic syndrome, which significantly increases the risk of cardiovascular disease. Continued stress on the pancreas gradually leads to prediabetes and type 2 diabetes. In parallel, fat accumulates in the liver with the development of non-alcoholic fatty disease and the risk of its progression. Women's reproductive function suffers: ovulation is disrupted, pregnancy becomes more difficult. The good news is that all of these processes are slowed down and partially reversed by losing weight and increasing physical activity.
- Prediabetes and type 2 diabetes
- Cardiovascular diseases
- Arterial hypertension
- Non-alcoholic fatty liver disease
- Ovulation disorders and infertility
- Gout and increased uric acid
What really helps
The most powerful tool is regular physical activity: the working muscle takes glucose from the blood without the participation of insulin, and strength exercises increase muscle mass, increasing sensitivity to the hormone for a long time. The second most important factor is weight loss: even minus 5–10 percent significantly improves performance. In nutrition, it is not prohibitions that are important, but structure: enough protein, vegetables, whole grains and legumes instead of refined carbohydrates, avoidance of sugary drinks. Sleep deserves special attention: chronic lack of sleep itself reduces insulin sensitivity. Medicines are prescribed by a doctor, and they complement, rather than replace, these measures. Dietary supplements and “cleanses” do not work.
- 150 minutes of moderate aerobic activity per week
- Strength training 2-3 times a week
- Weight reduction of 5–10 percent
- Enough protein, vegetables, fiber
- Avoiding sugary drinks and ultra-processed foods
- Sleep 7–8 hours in a stable mode
- Quitting smoking and limiting alcohol
- Drug therapy as prescribed by a doctor