what Insulin Resistance is? Overview. Do all diabetics have insulin resistance? Of course, not, there are two types of diabetes, Type 1, in which the pancreas doesn't produce insulin, and type two which pancreas produce enough insulin, but body cells receptors don't respond. But what insulin and insulin resistance are? Insulin is a polypeptide hormone secreted by beta cells of pancreatic islets that helps blood glucose to enter the body cells, where it is used for energy production. When the blood glucose level increase, your pancreas as a reflex releases insulin to keep glucose level in its’ normal range. Insulin Resistance is an impairment of target tissues (as liver, muscles and adipose tissues) biological response to insulin, which means that body cells don’t respond well to insulin; consequently, pancreatic cells will produce more insulin to overcome the hyperglycemia occurred and to help glucose enter the body cells, but what are the causes of insulin resistance? Insulin Resistance Causes. There are many causes that can lead to insulin resistance syndrome: 1-Genetics (Family History of Diabetes). 2-People who have lifestyle risk factors like obesity and physical inactivity. 3-Age 45 or older. 4-PCOs (Polycystic Ovary Syndrome). 5-History of gestational diabetes. 6-People with metabolic syndrome. 7-Some medications such as some antipsychotics and glucocorticoids. 8-Hormonal disorders, such as Cushing’s syndrome. Insulin Resistance Symptoms. “Many symptoms may appear as a sign of insulin resistance; however, it may be a silent disease, without any apparent symptoms.” 1- Fasting blood glucose level over 100mg/dl 2- Appearance of thickened dark skin patches especially on the back of the neck, elbow, knees, groins, or armpits, this skin discoloration called acanthosis nigricans. 3-skin tags. 4-Blood pressure rate of 130/ 80 or higher. 5-Obesity especially in the abdomen. 6- High triglyceride and low HDL level. Diagnosis of Insulin Resistance. 1- HbA1C test “reflects the average blood glucose level over the past 3 months” 5.7 to 6.4 percent. 2-Oral Glucose Tolerance Test (OGTT): 140 to 199 mg/dl. 3-HOMA-IR more than 3.8 %, it is widely utilized a measure of insulin resistance in clinical researches 4-Triglyceride/HDL ratio is greater than or equal to 2.5 in women and greater than or equal to 3.5 in men. Treatment Of Insulin Resistance. The main and most effective way for insulin resistance treatment depends on the patient himself. 1- Intensive lifestyle intervention:- Losing weight and making regular daily exercise, insulin resistance improved by 80% in the obese patients who lose 10% of their body weight through a healthy lifestyle ( healthy diet and regular exercise ); however, those who lose 10% of their weight by a healthy diet without exercise, has only 38% improvement in insulin resistance. 2-Metformine: which is considered first-line therapy for Type 2 Diabetes, studies showed starting metformin with Healthy lifestyle intervention improves insulin sensitivity to a higher percent, but we cannot use it in patients with kidney impairment as long as GFR is less than 30. 3-Glucagon- like peptide one inhibitors: are associated with weight loss, which has a positive impact on increasing insulin sensitivity, as Liraglutide which is FDA approved as an anti-obesity agent. 4-N-Acetyl Cysteine: Some new studies in the united kingdom approved the beneficial role of early intervention of N-acetyl cysteine “ as reactive oxygen species scavenger” in improving insulin resistance and reducing body fat.
