ENDOCRINOLOGIST IN GDAŃSK

Insulin Resistance – Causes, Symptoms, Diagnosis and Treatment

Insulin resistance, a condition affecting glucose homeostasis, is an increasingly common metabolic disorder. It’s characterized by reduced sensitivity of cells to insulin, leading to disturbances in glucose metabolism. If left untreated, insulin resistance can contribute to the development of type 2 diabetes and other serious health problems. In this article, we’ll take a closer look at the causes, symptoms, and treatment options for insulin resistance.

What causes insulin resistance?

Insulin resistance can be triggered by several factors, often appearing together. The most common include:

• Genetics – Family history plays a significant role. If your parents or siblings have insulin resistance, type 2 diabetes, or metabolic disorders, your risk is higher.

• Obesity – Excess body fat, especially visceral fat (located around internal organs), is one of the key risk factors. Visceral fat releases inflammatory substances that interfere with insulin function.

• Poor diet – Consuming too many processed foods, simple sugars, and saturated fats promotes insulin resistance. A high-calorie diet rich in ultra-processed products contributes to obesity and metabolic imbalances.

• Lack of physical activity – A sedentary lifestyle and insufficient exercise lower insulin sensitivity. Regular workouts improve metabolic health and support glucose regulation.

• Hormonal disorders – Conditions like polycystic ovary syndrome (PCOS) are often linked to insulin resistance. PCOS involves elevated levels of insulin and androgens, which impair cellular insulin response.

• Chronic stress – Prolonged stress increases cortisol levels, which may disrupt insulin function. Stress also contributes to unhealthy eating habits and physical inactivity.

Common symptoms of insulin resistance

Insulin resistance can develop silently over time, making early detection difficult. However, some signs may indicate its presence:

• Increased appetite – People with insulin resistance often experience sudden hunger pangs, especially cravings for sweets. High insulin levels lead to blood sugar drops, triggering hunger.

• Weight gain – Particularly around the abdominal area. Insulin encourages fat storage, making weight management more challenging.

• Fatigue – Many individuals feel chronically tired, even after enough sleep. Disrupted glucose metabolism results in low energy levels.

• Difficulty concentrating – “Brain fog,” trouble with focus or memory may be related to insulin resistance.

• Dark skin patches – Areas like the neck, armpits, or groin may show dark, velvety discoloration (acanthosis nigricans), often due to excess insulin.

• Irregular periods – In women, insulin resistance may disturb hormonal balance and cause menstrual irregularities or missed periods.

Diagnosis and treatment of insulin resistance

Diagnosis

Diagnosing insulin resistance typically involves a combination of clinical assessment, lab tests, and specialized evaluations. The most common diagnostic methods include:

• Oral Glucose Tolerance Test (OGTT) – Measures blood sugar levels before and after drinking a glucose solution. Abnormal results may indicate impaired glucose metabolism.

• Fasting insulin test – Elevated fasting insulin may signal insulin resistance.

• HOMA-IR index – Calculated using fasting glucose and insulin levels. Higher values suggest insulin resistance.

• Other lab tests – A lipid panel and HbA1c (glycated hemoglobin) help assess the patient’s overall metabolic health.

Treatment

Managing insulin resistance requires a comprehensive approach involving lifestyle changes, dietary improvements, physical activity, and in some cases, medication.

Lifestyle changes:

• Healthy diet – A well-balanced, low-glycemic diet rich in fiber, protein, and healthy fats is key. Avoid processed foods, refined sugars, and trans fats. Eat regular meals at consistent times to help stabilize blood glucose.

• Exercise – Regular aerobic activities (e.g., walking, running, swimming, cycling) and strength training improve insulin sensitivity and glucose metabolism.

• Stress reduction – Techniques such as meditation, yoga, or deep breathing can help lower cortisol levels and improve well-being.

Pharmacotherapy:

• Metformin – The most commonly prescribed drug for insulin resistance. It reduces glucose production in the liver and increases insulin sensitivity, particularly in people with excess weight.

• SGLT-2 inhibitors – Help eliminate glucose through urine and are often used alongside metformin.

• DPP-4 inhibitors – Boost incretin hormone levels, supporting better blood sugar control. Frequently used in combination therapies.

Health monitoring

Ongoing health monitoring is essential in managing insulin resistance and preventing complications.

Regular check-ups

Patients should routinely check blood glucose levels, lipid profile, and other key metabolic markers. Medical appointments help track treatment progress and make necessary adjustments.

Working with a dietitian

A qualified dietitian can create a personalized nutrition plan tailored to the patient’s needs and preferences. They also offer valuable lifestyle advice to help manage insulin resistance effectively.

Preventing insulin resistance

Prevention plays a crucial role. Here are some steps to reduce your risk:

• Eat a healthy, balanced diet – Include vegetables, fruits, whole grains, lean proteins, and good fats.

• Stay physically active – Regular movement improves insulin sensitivity and supports metabolic health.

• Avoid processed foods – Limit your intake of refined carbs, sugary snacks, and trans fats.

• Manage stress – Practice relaxation techniques like yoga or breathing exercises to keep stress in check.

• Schedule regular screenings – Early detection helps prevent complications and supports proactive management.