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What is Insulin resistance and Pre-Diabetes?Insulin resistance is a silent condition that increases the chances of developing diabetes and heart disease. Learning about insulin resistance is the first step towards making lifestyle changes that will help prevent diabetes and other health problems. What does insulin do?

After you eat, the food is broken down into glucose, the simple sugar that is the main source of energy for the body’s cells. But your cells cannot use glucose without insulin, a hormone produced by the pancreas. Insulin helps the cells take in glucose and convert it to energy. When the pancreas does not make enough insulin or the body is unable to use the insulin that is present, the cells cannot use glucose. Excess glucose builds up in the bloodstream, setting the stage for diabetes.

Being obese or overweight affects the way insulin works in your body. Extra fat tissue can make your body resistant to the action of insulin, but exercise helps insulin work well.

If you have insulin resistance, your muscle, fat and liver cells do not use insulin properly. The pancreas tries to keep up with the demand for insulin by producing more. Eventually, the pancreas cannot keep up with the body’s need for insulin, and excess glucose builds up in the bloodstream. Many people with insulin resistance have high levels of blood glucose and high levels of insulin circulating in their blood at the same time.

People with blood glucose levels that are higher than normal, but not yet in the diabetic range, have ‘pre-diabetes’. Doctors sometimes call this condition impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. If you have pre-diabetes, you have a higher risk of developing Type 2 diabetes, or non-insulin-dependent diabetes. Studies have shown that most people with pre-diabetes go on to develop Type 2 diabetes within ten years, unless they lose five to seven percent of their body weight, which is about ten to 15 pounds for someone who weights 200 pounds, by making modest changes in their diet and level of physical activity. People with pre-diabetes also have a higher risk of heart disease.

Type 2 Diabetes is sometimes defined as the form of diabetes that develops when the body does not respond properly to insulin, as opposed to Type 1 diabetes, in which the pancreas makes no insulin at all. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. Insulin resistance can also occur in people who have Type 1 diabetes, especially if they are overweight.

What causes insulin resistance?

Because insulin resistance tends to run in families, we know that genes are partly responsible. Excess weight also contributes to insulin resistance, because too much fat interferes with the muscles’ ability to use insulin. Lack of exercise further reduces the muscles’ ability to use insulin.

Many people with insulin resistance and high blood glucose have excess weight around the waist, high LDL (bad) blood cholesterol levels, low HDL (good) cholesterol levels, high levels of triglycerides (another fat in the blood), and high blood pressure, all conditions that also put the heart at risk. This combination of problems is referred to as the Metabolic Syndrome, or the insulin resistance syndrome (formerly called Syndrome X).

Insulin resistance and pre-diabetes usually have no symptoms. You may have one or both conditions for several years without noticing anything. If you have a severe form of insulin resistance, you may get dark patches of skin, usually on the back of your neck. Sometimes people get a dark ring around their neck. Other possible sites for these dark patches include elbows, knees, knuckles and armpits. This condition is called acanthosis nigricans.

If you have a mild or moderate form of insulin resistance, blood tests may show normal or high blood glucose and high levels of insulin at the same time.

Do you have insulin resistance or pre-diabetes?

Anyone 45 years or older should consider getting tested for Diabetes. If you are overweight and aged 45 or older, it is strongly recommended that you get tested. You should consider getting tested if you are younger than 45, overweight and have one or more of the following risk factors: