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Insulin resistance and prediabetes What we need to know

Insulin resistance and prediabetes

what is insulin

Insulin is a hormone produced by β cells of the pancreas, which is involved in glucose metabolism. Glucose enters the body with food and is a source of energy. It is absorbed by cells through insulin. If necessary, for example during starvation, liver cells can produce glucose (gluconeogenesis). When the level of glucose in the blood rises too much after a meal, the release of insulin is stimulated, which ensures that the excess sugar is converted and absorbed by the cells and thus maintains the blood glycemic level.

What is insulin resistance?

Insulin resistance is a condition when body cells (liver, muscle, fat) do not respond to insulin and cannot absorb excess glucose (sugar) from the blood. As a result of this, the pancreas increases the production and release of insulin in the blood by a compensatory mechanism in order to maintain the blood glucose level within the normal range.

What is prediabetes?

Prediabetes is a condition where blood glucose levels are high, but not high enough to be diagnosed as diabetes. Prediabetes occurs in people whose pancreatic β cells do not produce enough insulin, or who have insulin resistance. Over time, an imbalance between glucose uptake and insulin release/use leads to type 2 diabetes.

Who is more likely to develop insulin resistance and prediabetes?

People with a genetic predisposition and a sedentary lifestyle are more likely to develop insulin resistance and prediabetes, but there are other important risk factors. these are:

  • Overweight and obesity
  • Age above 45 years
  • Family history of diabetes
  • Arterial hypertension and hyperlipidemia
  • History of gestational diabetes
  • History of diseases of the cardiovascular system
  • Polycystic ovary syndrome and others.

People with metabolic syndrome—a combination of high blood pressure and elevated blood lipids along with increased abdominal circumference—also have a higher risk of developing prediabetes.

In addition to the listed risk factors, the development of insulin resistance is promoted by:

  • Current diseases with hormonal disorders. eg: Cushing's syndrome, acromegaly
  • some medicines, eg glucocorticoids, antipsychotics and some anti-HIV medicines)
  • Sleep disorders, sleep apnea.

Because it is impossible to change risk factors such as family history and age, we can change lifestyle-related risk factors: through diet, physical activity, and weight control. This will help us avoid the risks of developing insulin resistance and prediabetes.

What causes insulin resistance and diabetes?

The mechanism of development of insulin resistance and pre-diabetes is not fully substantiated, although scientific studies have confirmed the influence of weight and physical activity on the development of these processes.

Excess weight

One of the main causes of insulin resistance is abdominal and visceral obesity. A waist circumference greater than 100 cm in men and greater than 90 cm in women is usually associated with insulin resistance, regardless of whether a person's body mass index (BMI) falls within the normal range. Studies have proven that abdominal fat cells produce hormones and active substances that play an important role in the development of chronic inflammatory processes. The chronic inflammatory process plays an important role in the development of insulin resistance, prediabetes, type 2 diabetes and cardiovascular diseases (stroke, heart attack). Insulin resistance also causes fatty liver.

physical activity

Insufficient physical activity is directly related to insulin resistance and prediabetes. Regular physical activity improves the sensitivity of cells to insulin and makes it possible to maintain blood glucose levels within normal limits.

Symptoms of insulin resistance and prediabetes

Both conditions sometimes start completely asymptomatically. People with prediabetes sometimes have darkening of the skin in the natural folds and on the back-side surfaces of the neck. Small skin growths sometimes appear in the same areas. At the same time, the level of glucose in the blood is not so high that the symptoms of diabetes develop. However, vision problems (retinopathy) begin prematurely in some patients.

How to diagnose?

Suspicion of the diagnostics of prediabetes and insulin resistance is first made by anamnestic data, after which it is necessary to conduct a number of studies.

  • Fasting glucose determination
  • Determination of glucose in 1-2 hours after eating
  • Oral Glucose Tolerance Test (if needed) - Determines how insulin secreted after a meal copes with high glucose levels. Often, the fasting blood glucose level is normal, and only a tolerance test can determine insulin resistance. This test is also important for diagnosing gestational diabetes.
  • Glycated hemoglobin - determines the average rate of glycemia during the last 3 months.
  • HOMA-index – ratio between glucose and insulin concentration, which is an important criterion for diagnosing insulin resistance.

People with insulin resistance and prediabetes have a 2% increased risk of developing type 5 diabetes over the next 10-50 years.

  • If a person has obesity, or one or more of the listed risk factors, it is time to conduct research!
  • If the research data are normal, but you have risk factors (family history; obesity; age; passive lifestyle, etc.), it is recommended to repeat the research at least once every 3 years.

Synevo" offers diagnostic tests for insulin resistance and prediabetes:

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Synevo also offers profiles of diabetes studies

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