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Published on April 26, 2022

This silent health condition can lead to trouble

Insulin Resistance

Doctors call hypertension “the silent killer,” but the term could just as easily apply to insulin resistance because most people who have it are completely unaware of it. Endocrine researchers estimate that about 30 percent of Americans suffer from the condition.

And young people aren’t exempt. A recent study published in the Journal of Clinical Endocrinology & Metabolism surveyed 6,247 adults ages 18 to 44 over a decade. They discovered that about 40 percent of the people in the study developed insulin resistance.

“Insulin is a hormone that is made by the pancreas and you need insulin to help to take the blood sugar out of the blood and put it into cells so that they can use the sugar to do work,” explained Hyannis endocrinologist Sheila Maier, DO. “When people develop insulin resistance, that insulin is no longer working as well and you need more insulin to do the same job and then eventually the pancreas is not able to make enough insulin and people start to get higher blood sugars and also higher cholesterol levels.”

This silent blood sugar condition increases the risk of several serious health problems. It can lead to prediabetes, type 2 diabetes and fuel the growth of many different kinds of cancer, including cancers of the bladder, breast, colon, cervix, pancreas, prostate and uterus. It has been implicated in the development of Alzheimer’s disease and it doubles the risk of heart attacks and strokes.

In addition, insulin resistance is associated with non-alcoholic fatty liver, polycystic ovary syndrome and metabolic syndrome, Dr. Maier said. Part of the reason so many people don’t know they have insulin resistance is that there is no specific test for it.

“The symptoms from insulin resistance really comes from the problems it causes, so people can get a skin rash called acanthosis nigricans,” Dr. Maier said. “It’s a dark velvety skin rash and skin discoloration. Other symptoms tend to be things like higher blood sugars and higher cholesterol, so unless you do a laboratory evaluation you might not pick up on it.

When you have insulin resistance your pancreas works hard to keep up by making extra insulin. Over time, your pancreas won’t be able to keep up with the extra work and your blood sugar levels will go up, leading to pre-diabetes. Prediabetes is a fasting blood sugar between 100 and 125 and an A1C of 5.7 to 6.5. If you don’t make lifestyle changes, pre-diabetes will eventually turn into diabetes. Diabetes is a fasting blood sugar greater or equal to 126 with a A1C of greater than 6.5.

Risk factors for insulin resistance include a diet that is high in processed foods with a lot of fat and sugar. Weight is one of the key risk factors and different types of obesity seem to have a higher risk of insulin resistance. People with abdominal or visceral obesity who carry more weight in their mid-section tend to have higher rates of insulin resistance than people carrying weight that is more evenly distributed, Dr. Maier said.

“Genetics plays a role too,” she said. “Certain populations, like people with south and east Asia backgrounds tend to develop insulin resistance at lower body weights than others. Sometimes people’s medications increase their insulin resistance and they can develop sugar problems too.”

The biggest medication culprits are oral steroids like prednisone or hydrocortisone, but inhaled steroids taken for asthma or COPD don’t seem to have the same danger.

How to Avoid Insulin Resistance

“There is some pretty good evidence that exercise and weight loss really help to improve insulin resistance,” Dr. Maier said. “Weight loss of about five to seven percent of body weight has been shown to be effective in improving the blood sugar, cholesterol levels, blood pressure and, in people who have non-alcoholic fatty liver, can sometimes normalize the liver function.”

Swapping processed foods for healthier foods can also help. The Mediterranean Diet with its emphasis on fish, vegetables, fruits, olive oil and whole grains is a good place to start. It has the best data of any diet, Dr. Maier said.

The American Heart Association recommends 150 minutes of moderate exercise a week, which breaks down to about thirty minutes, five days a week.

For people with insulin resistance and prediabetes, the YMCA in Barnstable has a highly successful Diabetes Prevention Program. The program helps participants make lifestyle changes that will improve their health and lower their risk of developing type 2 diabetes. Research from the National Institutes of Health research shows that programs like the one at the Y can reduce the number of new cases of diabetes by 58 percent overall and by 71 percent in people over the age of 60.

“The Diabetes Prevention Program is very well recognized as being an excellent way for people who do have pre-diabetes to help prevent the development of diabetes,” Dr. Maier said.

For more information about when the next session will begin, call 508-362-6500, ext. 1230.