Insulin resistance involves:
Impaired Cellular Response: Cells in muscles, fat, and liver become less responsive to the action of insulin, a hormone that regulates blood sugar levels.
Hyperinsulinemia: The pancreas compensates for insulin resistance by producing more insulin, leading to elevated levels of insulin in the blood.
Glucose Uptake Dysfunction: Reduced efficiency of glucose uptake by cells, resulting in elevated blood glucose levels (hyperglycemia).
Inflammation: Chronic low-grade inflammation associated with obesity and metabolic syndrome contributes to the development and progression of insulin resistance.
Complications: Insulin resistance can lead to type 2 diabetes, cardiovascular disease, and other metabolic disorders.
Clinical Evaluation
Symptoms: Assessment of symptoms such as fatigue, increased hunger, difficulty concentrating, and acanthosis nigricans (darkened skin patches).
Physical Examination: Examination findings may include signs of obesity, especially central obesity (excess fat around the abdomen), and skin changes indicative of insulin resistance.
Diagnostic Tests: Blood tests to measure fasting glucose levels, fasting insulin levels, hemoglobin A1c (HbA1c), and lipid profile. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index may also be used to assess insulin resistance.
Increased hunger and cravings for carbohydrates.
Fatigue and low energy levels.
Difficulty concentrating and brain fog.
Weight gain, particularly around the abdomen.
Dark patches of skin (acanthosis nigricans) on the neck, armpits, or groin.
Elevated blood sugar levels and lipid abnormalities.
Management aims to improve insulin sensitivity and prevent complications:
Dietary Changes: Adopting a balanced diet rich in whole foods, fiber, and healthy fats, while reducing intake of refined carbohydrates and sugars.
Physical Activity: Regular exercise, including both aerobic and resistance training, to improve insulin sensitivity and promote weight loss.
Weight Management: Achieving and maintaining a healthy weight through diet and exercise to reduce the burden of insulin resistance.
Medications: Medications such as metformin to improve insulin sensitivity and control blood sugar levels.
Lifestyle Modifications: Managing stress, getting adequate sleep, and avoiding smoking and excessive alcohol consumption.
Monitoring and Follow-Up: Regular monitoring of blood glucose levels, lipid profile, and overall health to track progress and adjust treatment as needed.