Early Signs and Symptoms of Insulin Resistance You Shouldn’t Ignore

What Is Insulin Resistance?

Insulin resistance happens when the muscle, fat, and liver cells of your body do not respond to insulin as they should. The function of insulin is to bring glucose from your blood into your cells, where it is used as energy. If your body's cells are resistant to insulin, then glucose builds up in the blood rather than entering your cells. In response to this, the pancreas begins to produce greater amounts of insulin in order to allow glucose to enter the cells. This is called hyperinsulinemia. When the pancreas can continue to meet the demands placed upon it by continued glucose build-up in the blood, your blood sugar level remains within a healthy range. At times, you may not experience any symptoms at all. However, there comes a point in time when the pancreatic beta cells begin to burn out. Once the cells in the pancreas can no longer produce sufficient insulin to adequately compensate for the resistance, blood sugar levels increase, and you will progress to having either pre-diabetic or diabetic conditions.

Why Early Detection of Insulin Resistance Matters 

It is very uncommon for individuals who are affected with insulin resistance to realize their condition exists until they are well into its advanced stages. By the time an individual experiences clear symptoms of their condition, it usually means that the individual has reached a stage where their body is already transitioning towards developing pre-diabetes or type 2 diabetes. 

Early detection of insulin resistance is valuable, as it is still possible to manage its effects through targeted changes in daily activities. Making specific choices regarding what you eat and how much you exercise, along with maintaining your current weight, can effectively decrease insulin resistance, lower your blood sugar, decrease your total cholesterol, and lower your blood pressure. Allowing early detection of insulin resistance provides opportunities for preventing or delaying the onset of type 2 diabetes and reducing risks associated with heart disease and metabolic syndrome.

Early Signs and Symptoms of Insulin Resistance 

Early signs and symptoms of insulin resistance. Perhaps one of the most difficult challenges of recognizing insulin resistance is identifying its presence prior to when its symptoms begin. Before your pancreas can no longer compensate, you will generally have few, if any, identifiable symptoms. The symptoms that emerge later in the course of the illness can be quite subtle and easily attributed to another health issue. Common indicators include:

Acanthosis Nigricans: 

Thickening of the skin in the armpit area, back of the neck, or groin. 

Skin tags: 

Small pieces of skin that grow at places where the skin folds onto itself. 

Fatigue: 

Feeling extremely tired, despite getting adequate rest. This is due to cells not being able to use glucose for energy production. 

Increased hunger: 

Always hungry regardless of recent meals eaten, since glucose is not absorbed correctly.

Urinating excessively: 

Indicative of elevated glucose levels, causing an excessive amount of urine production.

Blurry vision: 

Caused by raised glucose levels in the eyes' fluid. 

Gain or loss of unexplained weight:

Especially around the midsection. 

Microbial yeast infections: 

Repeated infections could be a result of elevated blood glucose levels, allowing yeast to thrive.

You might also notice some eye problems that could be signs of eventual diabetic retinal damage, so check-ups with an ophthalmologist will be helpful.

Who Is at Risk of Developing Insulin Resistance?

Although anyone can get insulin resistance, certain factors greatly increase your chances. Those include: 

• overweight or obese, especially excess abdominal fat 
• age 45+ years old 
• lack of physical activity or being sedentary 
• family member(s) diagnosed with diabetes or insulin resistance 
• history of gestational diabetes 
• blood hypertension or high cholesterol 
• sleep disorders such as sleep apnea 
• current smoker 
• personal and or family history of cardiovascular disease or stroke

While some risk factors like age and family history cannot be altered by you, many others, such as diet, exercise, and weight loss, are entirely within your control.

What Causes Insulin Resistance?

Causes of insulin resistance come from both acquired and inherited sources.

Examples of acquired sources include:

• Excess body fat (especially around internal organs) 
• Lack of physical activity 
• Eating too much processed food, refined carbohydrates, sugar-rich diets, and saturated fats

Some types of medications can cause or worsen existing insulin resistance. Examples include: 

• Corticosteroids (such as prednisone)
• Diuretics
• Statins (used to treat cholesterol)
• Antiretrovirals (medications for HIV/AIDS)

Genetic diseases that lead to insulin resistance include the following: 

• Type A insulin resistance syndrome 
• Myotonic dystrophy 
• Inherited lipodystrophies 
• Donohue syndrome

How Is Insulin Resistance Diagnosed? 

No single routine laboratory test exists specifically for diagnosing insulin resistance. Instead, diagnosis involves assessing your overall medical history, performing a complete physical exam, reviewing symptoms you report, and ordering several different blood tests. Your doctor will evaluate your:

• Family history
• Weight status 
• Activity levels
• Any reported symptoms

Your doctor may recommend that you undergo various blood tests, such as:

• Fasting plasma glucose test: to determine if your blood sugar levels are abnormally high during fasting.
• HbA1c blood test: measures your average blood sugar levels over 3 months.
• Lipid panel: evaluates your cholesterol levels and triglycerides.

While none of these tests diagnose insulin resistance directly, collectively they provide evidence that can suggest you have developed prediabetes or type 2 diabetes, and possibly if insulin resistance is playing a role in your symptoms.

Foods That Help Improve Insulin Sensitivity

Diet plays a large part in treating insulin resistance. As previously mentioned, high GI foods rapidly elevate blood sugar levels, placing additional burden on the pancreas and worsening insulin resistance with time. High GI foods include: 

• White bread
• Potatoes
• Instant oatmeal
• Cookies
• Biscuits
• Cakes
• Sweetened beverages
• Watermelon
• Dates

Low GI foods gradually increase blood sugar and improve insulin sensitivity. These include: 

• Legumes
• Beans 
• Vegetables, non-starchy leafy greens such as asparagus, broccoli, etc. 
• Apples
• Berries
• Nuts 
• Grains (whole grain) 
• Fish
• Lean poultry
• Dairy

References:

• Cornier, M. A., Dabelea, D., Hernandez, T. L., Lindstrom, R. C., Steig, A. J., Stob, N. R., Van Pelt, R. E., Wang, H., & Eckel, R. H. (2008). The metabolic syndrome. Endocrine Reviews, 29(7), 777–822. 
• Huang, P. L. (2009). A comprehensive definition for metabolic syndrome. Disease Models and Mechanisms, 2(5), 231–237. 
• Kahn, S. E., Hull, R. L., & Utzschneider, K. M. (2006). Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature, 444(7121), 840–846. 
• Reaven, G. M. (1988). Banting lecture 1988: Role of insulin resistance in human disease. Diabetes, 37(12), 1595–1607. 
• Wilcox, G. (2005). Insulin and insulin resistance. Clinical Biochemist Reviews, 26(2), 19–39.