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Causes Of Severe Insulin Resistance

Signs Of Insulin Resistance

Signs Of Insulin Resistance

What is insulin resistance? Insulin is a hormone made by your pancreas. It allows your cells to use glucose (sugar) for energy. People with insulin resistance have cells throughout their bodies that don’t use insulin effectively. This means the cells have trouble absorbing glucose, which causes a buildup of sugar in their blood. If your blood glucose levels are higher than normal, but not high enough to be considered type 2 diabetes, you have a condition called prediabetes caused by insulin resistance. It’s not entirely clear why some people develop insulin resistance and others don’t. A sedentary lifestyle and being overweight increases the chance of developing prediabetes and type 2 diabetes. The effects of insulin resistance Insulin resistance typically doesn’t trigger any noticeable symptoms. You could be insulin resistant for years without knowing, especially if your blood glucose levels aren’t checked. The American Diabetes Association (ADA) estimates that nearly 70 percent of individuals with insulin resistance and prediabetes will go on to develop type 2 diabetes if significant lifestyle changes aren’t made. Some people with insulin resistance may develop a skin condition known as acanthosis nigricans. This condition creates dark patches often on the back of the neck, groin, and armpits. Some experts believe it may be caused by a buildup of insulin within skin cells. There’s no cure for acanthosis nigricans, but if caused by a specific condition, treatment may allow for some of your natural skin color to return. Insulin resistance increases the risk of being overweight, having high triglycerides, and having elevated blood pressure. Since insulin resistance increases your risk for progressing to diabetes, you may not notice right away if you develop Continue reading >>

What Causes Insulin Resistance? Lipid Overload

What Causes Insulin Resistance? Lipid Overload

Over the past year I have interacted with hundreds of people with diabetes, and have come to learn one very important lesson that has changed my view of diabetes altogether. This realization came to me early on in my career as a nutrition and fitness coach for people with diabetes, and continues to hold true. While insulin resistance is a condition that is most commonly associated with type 2 diabetes, an increasing body of evidence is now shedding light on the fact that insulin resistance is a common thread that underlies many health conditions previously unassociated with blood sugar, including (but not limited to) heart disease, diabetes, atherosclerosis, the metabolic syndrome, obesity and cancer. What that means is simple: insulin resistance significantly increases your risk for the development of a collection of health conditions that can significantly reduce your quality of life and decrease your life expectancy. Watch this video for a synopsis of the causes of insulin resistance: What is insulin and why should you care? Insulin is a hormone which is released by the pancreas in response to rising blood glucose. When you consume carbohydrates, the glucose that enters the bloodstream knocks on the door of the beta cells in the pancreas as a signal to make insulin. Insulin serves as the key that unlocks the door to allow glucose to enter body tissues. Insulin tells your cells “Yoo hoo! Pick up this glucose. It’s all over the place.” Without insulin, cells in the liver, muscle, and fat have a difficult time vacuuming up glucose from the blood. These tissues are capable to vacuuming up only a small percentage (5-10%) of the glucose in circulation without the help of insulin. When insulin is present, the amount of glucose that can be transported into tissues sign Continue reading >>

Insulin Resistance

Insulin Resistance

What medical conditions are associated with insulin resistance? While the metabolic syndrome links insulin resistance with abdominal obesity, elevated cholesterol, and high blood pressure; several other medical other conditions are specifically associated with insulin resistance. Insulin resistance may contribute to the following conditions: Type 2 Diabetes: Overt diabetes may be the first sign insulin resistance is present. Insulin resistance can be noted long before type 2 diabetes develops. Individuals reluctant or unable to see a health-care professional often seek medical attention when they have already developed type 2 diabetes and insulin resistance. Fatty liver: Fatty liver is strongly associated with insulin resistance. Accumulation of fat in the liver is a manifestation of the disordered control of lipids that occurs with insulin resistance. Fatty liver associated with insulin resistance may be mild or severe. Newer evidence suggests fatty liver may even lead to cirrhosis of the liver and, possibly, liver cancer. Arteriosclerosis: Arteriosclerosis (also known as atherosclerosis) is a process of progressive thickening and hardening of the walls of medium-sized and large arteries. Arteriosclerosis is responsible for: Other risk factors for arteriosclerosis include: High levels of "bad" (LDL) cholesterol Diabetes mellitus from any cause Family history of arteriosclerosis Skin Lesions: Skin lesions include increased skin tags and a condition called acanthosis nigerians (AN). Acanthosis nigricans is a darkening and thickening of the skin, especially in folds such as the neck, under the arms, and in the groin. This condition is directly related to the insulin resistance, though the exact mechanism is not clear. Acanthosis nigricans is a cosmetic condition strongly Continue reading >>

Insulin Resistance Causes And Symptoms

Insulin Resistance Causes And Symptoms

One in three Americans—including half of those age 60 and older1— have a silent blood sugar problem known as insulin resistance. Insulin resistance increases the risk for prediabetes, type 2 diabetes and a host of other serious health problems, including heart attacks, strokes2 and cancer.3 What is Insulin Resistance? Insulin resistance is when cells in your muscles, body fat and liver start resisting or ignoring the signal that the hormone insulin is trying to send out—which is to grab glucose out of the bloodstream and put it into our cells. Glucose, also known as blood sugar, is the body’s main source of fuel. We get glucose from grains, fruit, vegetables, dairy products, and drinks that bring break down into carbohydrates. How Insulin Resistance Develops While genetics, aging and ethnicity play roles in developing insulin sensitivity, the driving forces behind insulin resistance include excess body weight, too much belly fat, a lack of exercise, smoking, and even skimping on sleep.4 As insulin resistance develops, your body fights back by producing more insulin. Over months and years, the beta cells in your pancreas that are working so hard to make insulin get worn out and can no longer keep pace with the demand for more and more insulin. Then – years after insulin resistance silently began – your blood sugar may begin to rise and you may develop prediabetes or type 2 diabetes. You may also develop non-alcoholic fatty liver disease (NAFLD), a growing problem associated with insulin resistance that boosts your risk for liver damage and heart disease. 5 Signs and Symptoms of Insulin Resistance Insulin resistance is usually triggered by a combination of factors linked to weight, age, genetics, being sedentary and smoking. - A large waist. Experts say the be Continue reading >>

Insulin Resistance: Causes, Symptoms And Prevention

Insulin Resistance: Causes, Symptoms And Prevention

Insulin, a hormone made by the pancreas, allows cells to absorb glucose so that it can be used as energy. The cells of individuals with insulin resistance are unable to use insulin effectively. When cells cannot absorb glucose, it builds up in the blood. If glucose levels are higher than normal, but not high enough to be diagnostic for diabetes, it is referred to as prediabetes. This page will look at the current understanding of insulin resistance and explain how it is a risk factor for both diabetes and other conditions. The article will also explain the signs and how it can be avoided. Contents of this article: Here are some key points about insulin resistance. More detail and supporting information is in the main article. Insulin resistance itself does not present any symptoms if it occurs without prediabetes or diabetes Blood sugar levels with insulin resistance are normal Insulin resistance alone is not treated, but preventing prediabetes or diabetes from developing can be achieved through lifestyle measures What is insulin resistance? Insulin resistance increases the risk of developing prediabetes, and, eventually, type 2 diabetes. Around 15-30 percent of people with prediabetes go on to be diagnosed with type 2 diabetes within 5 years, according to figures from the Centers for Disease Control and Prevention (CDC). Similarly, the American Heart Association (AHA) say that about half of people with high blood sugar go on to develop type 2 diabetes within a decade. The AHA also point out that this means half of these people do not develop diabetes - "your choices make a difference." In other words, individuals can reduce their chances of progressing to type 2 diabetes in the future by making some preventive lifestyle changes. Not only that, but these steps can also Continue reading >>

Prediabetes & Insulin Resistance

Prediabetes & Insulin Resistance

What is insulin? Insulin is a hormone made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood. Insulin plays a major role in metabolism—the way the body uses digested food for energy. The digestive tract breaks down carbohydrates—sugars and starches found in many foods—into glucose. Glucose is a form of sugar that enters the bloodstream. With the help of insulin, cells throughout the body absorb glucose and use it for energy. Insulin's Role in Blood Glucose Control When blood glucose levels rise after a meal, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to cells throughout the body. Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels. Insulin stimulates the liver and muscle tissue to store excess glucose. The stored form of glucose is called glycogen. Insulin also lowers blood glucose levels by reducing glucose production in the liver. In a healthy person, these functions allow blood glucose and insulin levels to remain in the normal range. What happens with insulin resistance? In insulin resistance, muscle, fat, and liver cells do not respond properly to insulin and thus cannot easily absorb glucose from the bloodstream. As a result, the body needs higher levels of insulin to help glucose enter cells. The beta cells in the pancreas try to keep up with this increased demand for insulin by producing more. As long as the beta cells are able to produce enough insulin to overcome the insulin resistance, blood glucose levels stay in the healthy range. Over time, insulin resistance can lead to type 2 diabetes and prediabetes because the bet Continue reading >>

Insulin Resistance: Causes, Symptoms, Diagnosis, And Consequences | Everyday Health

Insulin Resistance: Causes, Symptoms, Diagnosis, And Consequences | Everyday Health

RELATED: Everything You Need to Know About Insulin if You Have Type 2 Diabetes Understanding Insulin Resistance and Its Effect on Blood Sugar Control Although the production and release of insulin is a natural metabolic response after eating, some people don’t use insulin properly. To receive energy, your cells, fat, and muscles must be able to absorb the glucose in your bloodstream. If your body doesn’t respond well to insulin, glucose can build up in your blood and raise your blood sugar level. To help you maintain a normal blood sugar level, your pancreas compensates for this resistance by releasing more insulin. (3) The effects of insulin resistance on the body vary from person to person. Sometimes, the increased production of insulin by the pancreas is enough to overcome insulin resistance and normalize blood sugar levels. But other times, the pancreas is unable to produce sufficient amounts of insulin to overcome the resistance. This triggers high blood sugar and other health problems. (3) Although insulin resistance can exist on its own without another diagnosis, it relates to certain health conditions, too. Here are a few: If your pancreas struggles to produce enough insulin to handle the glucose in your body, your blood sugar level can become mildly elevated and you may develop prediabetes . This means your blood sugar is higher than normal but not high enough to be diagnosed with diabetes. This condition — which affects about 84.1 million people — is a precursor to type 2 diabetes . Having prediabetes also is associated with an increased risk for heart disease, stroke, eye problems, and kidney disease. In the case of prediabetes, your pancreas works overtime to secrete enough insulin to regulate your blood sugar. But if your pancreas can’t keep up w Continue reading >>

Severe Insulin Resistance: Pathologies

Severe Insulin Resistance: Pathologies

Audrey Melvin and Anna Stears July 11, 2017 Vol 34.6 July / August 2017 In parallel with the increasing prevalence of obesity, rates of insulin resistance and its associated complications have increased; however, insulin resistance is not only a disease of the overweight and obese. Disorders of adipose tissue expandability and insulin receptor signalling cause syndromes of severe insulin resistance that may go unrecognised in clinical practice but whose metabolic complications are significant and often the initial presentation of the condition. This review will discuss the differing pathologies mediating insulin resistance that may be seen in clinical practice and will outline the phenotypic characteristics that may allow their differentiation. Copyright 2017 John Wiley & Sons. A 43-year-old woman had a diagnosis of type 1 diabetes. She was diagnosed with diabetes during pregnancy and remained dependent on insulin thereafter. Her past medical history also included coeliac disease, hypertension and hyperlipidaemia, specifically hypetriglyceridaemia. Her family history was significant for cardiovascular disease with both her sister and mother having had a myocardial infarction under the age of 50, respectively. She was noted by an allied health professional to have excess fat accumulated around her neck which differed greatly from her fat deposition elsewhere. The woman reported that she had always been thin with prominent musculature. Her medical therapy included multiple daily injections of insulin analogues (170 units/day), losartan and rosuvastatin. On examination, her BMI was 23.7kg/m2 and there was an absence of subcutaneous fat on her limbs and trunk, and reduced breast tissue. There was prominent fat around her neck and face and no other findings. Pertinent labor Continue reading >>

What Is Severe Insulin Resistance?

What Is Severe Insulin Resistance?

Severe insulin resistance and lipodystrophy are rare metabolic disorders. They occur when the body does not use the insulin it produces properly. Insulin is a hormone (a chemical signal that travels in the bloodstream) made by the pancreas.It controls how the body uses sugars and fats and is essential for life. Its absence is the underlying problem in type 1 diabetes. However, from person to person there are significant differences in how sensitive the tissues of the body are to insulin. In other words, in some people a very small amount of insulin produces a large change in the blood levels of glucose and fats (these people are said to be very insulin sensitive), while in others much larger amounts are required to produce the same change (these people are said to be insulin resistant). Those with severe insulin resistance are those whose bodies respond least well to insulin. Although many with severe insulin resistance do go onto develop diabetes, severe insulin resistance is NOT the same as diabetes: as long as the pancreas can produce enough insulin to overcome the insulin resistance diabetes does not develop. However even before diabetes appears, insulin levels in the body may be extremely high, and this can produce a range of different problems in its own right. Rarely, people are born with severe insulin resistance and remain severely insulin resistant throughout their lives. Far more frequently insulin resistance develops only at puberty or in later life, while in some people it is only a temporary condition caused by other situations or illnesses. Most commonly a tendency towards insulin resistance is inherited, but only in the presence of environmental or lifestyle factors does it become a problem. Consequences of severe insulin resistance include development Continue reading >>

Insulin Resistance: Definition And Clinical Spectrum

Insulin Resistance: Definition And Clinical Spectrum

INTRODUCTION Insulin resistance can be broadly defined as a subnormal biological response to normal insulin concentrations. By this definition, it may pertain to many biological actions of insulin in many tissues of the body. Typically, however, in clinical practice, insulin resistance refers to a state in which a given concentration of insulin is associated with a subnormal glucose response [1]. The term first came into use several years after the introduction of insulin therapy in 1922 to describe occasional diabetic patients who required increasingly large doses of insulin to control hyperglycemia. Most of these patients developed insulin resistance secondary to antibodies directed against the therapeutic insulin, which at that time was both impure and derived from non-human species [2]. Antiinsulin antibodies are rare in patients treated with recombinant human insulin, and the spectrum of clinical disorders in which insulin resistance plays a major role has changed markedly. Insulin resistance, rather than being a rare complication of the treatment of diabetes, is now recognized as a component of several disorders, including the following (table 1): Extreme insulin-resistance syndromes, such as the type B syndrome with autoantibodies against the insulin receptor [3], and rare inherited disorders, such as Leprechaunism with insulin-receptor mutations [4] and the lipodystrophic states [5]. Impaired glucose tolerance and type 2 diabetes mellitus. Obesity, stress, infection, uremia, acromegaly, glucocorticoid excess, and pregnancy, which cause secondary insulin resistance. Common disorders such as the metabolic syndrome, hypertension, hyperlipidemia, coronary artery disease, the polycystic ovary syndrome (PCOS), and ovarian hyperthecosis, in which the mechanism of the a Continue reading >>

Stress And Acute Insulin Resistance

Stress And Acute Insulin Resistance

We all know stress is a factor in blood sugar management. We know that stress triggers the release of cortisol and adrenaline into the bloodstream, and these hormones increase blood sugar. We know that beyond the purely physiological effects of stress, chronic stress can lead to depression, which in turn can lower our motivation for blood sugar management and lead to feelings of hopelessness that often go hand-in-hand with poor choices in diet, lack of exercise, and more. We know stress is a danger that has real effects on our ability to manage diabetes. But stress has one more trick up its sleeve that I wasn’t even aware of until recently. Let me give a little personal backstory before the science — I’ve been in a fairly stressed out, wretched state for the past several months. So much so, in fact, that I wasn’t even aware of how stressed out and miserable I was until a close family member kindly (but directly) informed me that communicating with me was becoming an exceedingly unpleasant experience. A quick search through my e-mail sent folder confirmed this. Nearly every communication was a list of “what’s wrong today” and nothing more. I read through my Facebook history, too — mostly just angry, irritable posts about how hopeless the future will be. During the same stretch of time, I noticed my blood sugars were simply skyrocketing. I was at one point DOUBLING my long-acting dose. That’s right — doubling. It was as off-kilter as I can remember it being at any point over the past few years. I understood that the stress I was experiencing was undoubtedly part of the problem, but it was hard for me to imagine that stress could cause such a massive surge. But in the days after having that balloon so graciously popped by said family member, I have seen Continue reading >>

Treatment Approach To Patients With Severe Insulin Resistance

Treatment Approach To Patients With Severe Insulin Resistance

Go to: Evaluating Patients There are several known causes of severe insulin resistance, including several rare disorders and genetic conditions (Table 1) (3). Several medications are known to contribute to insulin resistance, including glucocorticoids, protease inhibitors, atypical antipsychotics, and calcineurin inhibitors. In patients with severe insulin resistance, an effort should be made to discontinue such agents or switch to alternative medications if possible (5). Poor medication-taking behaviors or “pseudoresistance” should be ruled out before modifying or intensifying therapy. Pseudoresistance may be the result of nonadherence, poor injection technique, improper insulin storage, or malingering for secondary gain. Pseudoresistance can be ruled out by conducting a modified insulin tolerance test (3). During such a test, patients are administered a witnessed dose of short-acting insulin in the clinic, and their blood glucose is monitored every 30 minutes for a period of 4–8 hours. Patients should be fasting for the test and should have a blood glucose level >150 mg/dL. A witnessed insulin dose approximately equal to what an average person with diabetes might require (insulin dose [units] = blood glucose [mg/dL] – 100 / (1,500 / weight [kg] × 1.0)] should be given. If there is not an appropriate drop in blood glucose within 4 hours, a second dose should be given. If normoglycemia or hypoglycemia is not achieved after either dose, the test confirms that a patient likely has severe insulin resistance. Continue reading >>

Insulin Resistance Syndromes

Insulin Resistance Syndromes

Diagnosis Biochemical diagnostic thresholds for severe insulin resistance (IR) are arbitrary, and should ideally be defined relative to BMI-adjusted population normal ranges, however one set of approximate diagnostic criteria is as follows: A: Non-diabetic and B.M.I. <30 kg/m2 Fasting insulin above 150 pmol/l OR Peak insulin on oral glucose tolerance testing above 1,500 pmol/l B: Absolute insulin deficiency and B.M.I. <30 kg/m2 Exogenous insulin requirement > 3U/kg/day. C: Partial beta cell decompensation and/or B.M.I. >30 kg/m2 Insulin levels are more difficult to interpret in the context of obesity or pre-existing diabetes, where glucotoxicity, and mixtures of endogenous and exogenous insulin in the circulation confuse the biochemical picture. In these settings the clinical history and features such as acanthosis nigricans are particularly useful in making a diagnosis of likely monogenic severe IR. Subjective clinical judgement is also required. Generic clinical features of severe insulin resistance Severe insulin resistance (IR) usually presents in one of three ways: Persistent hyperglycaemia despite large doses of insulin in patients with diabetes - Note, however, that many cases are unrecognised in the prediabetic phase. Indeed, a very common early feature of severe IR is spontaneous and symptomatic postprandial hypoglycaemia which may require medical intervention. This may dominate the clinical picture for years before hyperglycemia supervenes, which only occurs in the face of beta cell decompensation. Acanthosis Nigricans - The commonest presentation of monogenic severe IR is with the skin condition acanthosis nigricans (Figure 1). Ovarian hyperandrogenism, or “Polycystic Ovary Syndrome” - This may be severe, and oligo- or amenorrhoea are frequently the first Continue reading >>

Insulin Resistance

Insulin Resistance

Tweet Insulin resistance is the name given to when cells of the body don’t respond properly to the hormone insulin. Insulin resistance is the driving factor that leads to type 2 diabetes, gestational diabetes and prediabetes. Insulin resistance is closely associated with obesity; however, it is possible to be insulin resistant without being overweight or obese. Modern research has shown that insulin resistance can be combatted by treatment methods that reduce how much insulin the body is producing or taking via insulin injections or insulin pumps. Reducing insulin resistance can be achieved by following low-carbohydrate and ketogenic diets. What is insulin resistance? The role of insulin is to allow cells of the body to take in glucose to be used as fuel or stored as body fat. [282] It also means that glucose is more likely to build up in the blood and this can lead to too high blood sugar levels. When the body becomes resistant to insulin, it tries to cope by producing more insulin. People with insulin resistance are often producing too more insulin than healthy people. Producing too much insulin is known as hyperinsulinemia. Symptoms of insulin resistance Initially, insulin resistance presents no symptoms. The symptoms only start to appear once it leads to secondary effects such as higher blood sugar levels. When this happens, the symptoms may include: Lethargy (tiredness) Hunger Difficulty concentrating (brain fog) Other signs that often appear in people with insulin resistance include: Weight gain around the middle (belly fat) High blood pressure High cholesterol levels If insulin resistance develops into prediabetes or type 2 diabetes, the symptoms will include increased blood glucose levels and more of the classic symptoms of type 2 diabetes. Causes of insulin r Continue reading >>

Insulin Resistance

Insulin Resistance

A A A What is Insulin Resistance? Insulin is a hormone that is produced by the beta cells found in the pancreas. Insulin is an important hormone that has many actions within the body including those involved in metabolism (control) of carbohydrates (sugars and starches), lipids (fats), and proteins. When insulin resistance develops, tissues in the body – particularly muscle and fat tissues- do not respond appropriately to insulin. In fact, more insulin is needed to elicit the same response from these tissues. As a result, higher levels of insulin are needed in order for insulin to continue to exert its physiologic effect. There are many causes of insulin resistance, including a strong association with genetics (an inherited component). In addition, insulin resistance is often associated with the following conditions: infection or severe illness, the metabolic syndrome, obesity, pregnancy, steroid use and with other medications, and Aside from the well known association of insulin resistance with the metabolic syndrome, abdominal obesity, elevated cholesterol levels, and high blood pressure; there are several other medical conditions that are associated with insulin resistance specifically. While the associations are clear, whether insulin resistance is the cause of these conditions is not yet known. While insulin resistance is usually seen long before diabetes develops, in cases in which medical attention has lapsed, insulin resistance can present as type 2 diabetes. The accumulation of fat in the liver is a manifestation of the disordered control of lipids that occurs with insulin resistance. The extent of liver damage can range from mild to severe. Newer evidence suggests that fatty liver may even lead to cirrhosis of the liver, and possibly liver cancer. Insulin re Continue reading >>

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