Everyone would have heard of diabetes whether it be type 1 or type 2 (I will go into more detail on these conditions in a coming article), but do you know what Insulin Resistance or Metabolic Syndrome are and how they could be silently affecting you or someone you know?
What is Insulin Resistance?
Insulin Resistance (IR) is when elevated insulin levels are being released and required to keep sugar levels normal. IR produces a biological response – impaired sensitivity to insulin assisting in glucose clearance. Therefore the pancreatic ß cell increases secretion of insulin to maintain normal blood glucose levels in muscle and adipose (fat) tissue which equals impaired glucose metabolism. When a person needs to produce and secrete an increased amount of insulin, they run the risk of (over time) not being able to lower their blood sugar levels.
Development of IR is generally due to excess weight, excessive carbohydrate intake, a sedentary lifestyle and genetics can play a role. All of these elements can contribute to inflammation in the body and IR is strongly linked to inflammation within the body. The consequences of IR are of more concern as they can be varied and include:
- Low HDL Cholesterol (good cholesterol);
- Increased risk of blood clots
- Increase of intra-abdominal fat
- Elevated blood sugar
- High blood pressure
- Elevated triglycerides (blood fats)
- Inflammation of the liver and potential cirrhosis
- Sleep apnoea
- Polycystic Ovarian syndrome (PCOS)
- Changes in thyroid function
A person with IR doesn’t necessarily develop diabetes (although their risk is doubled), but those that require large quantities of insulin may manifest the classic symptoms of diabetes such as needing to go the toilet frequently, excessive thirst, excessive hunger/increased appetite and weight loss.
There is no single test to diagnose IR, but several pathology tests can be done and monitored to assess if a person is insulin resistant.
The two main ways to manage IR is through weight loss (lower carbohydrate diet with good fats and protein) and reducing inflammation. Although not all insulin resistant people are overweight. A study which was conducted over 60 years on the mechanisms of blood sugar balance in the body concluded that 50% of obese individuals in the USA not diagnosed with diabetes were insulin resistant and 25% of non-obese individuals also have IR.
What is Metabolic Syndrome?
Metabolic Syndrome (Mets) has also been commonly referred to as Syndrome X and these two names are interchangeable.
There are many factors that can cause a person to have Mets such as abdominal fat, sedentary lifestyle, certain dietary choices, advancing age and certain drugs can all be potential risk factors. Mets is usually diagnosed when a person has at least 3 or more of the following:
- Obesity – in particular abdominal obesity
- Insulin resistance
- High blood pressure
- Abnormal amounts of cholesterol and triglycerides in the blood
The diseases/conditions associated with Mets are concerning and include:
- Twice the risk of cardiovascular disease
- Five times the risk of Type 2 diabetes
- Polycystic ovarian syndrome (PCOS)
- Chronic kidney disease
- Non-alcoholic fatty liver disease
Managing Mets is also along the same lines as managing IR although more dietary and lifestyle measures are needed to reduce elevated blood pressure, cholesterol and triglycerides, plus weight loss, stabilising blood sugar levels and reducing inflammation.
If you are concerned that you might be insulin resistant or have metabolic syndrome, book an appointment with Megan to discuss further. Even if you have a family history of diabetes it is worth checking whether you may have insulin resistance.
Megan will look more closely at Diabetes our March clinic news.