Insulin Resistance and obesity
Definition: Insulin resistance is a state in which a given concentration of
insulin produces a less-than-expected biological effect 1. It may also be
defined as the need for 200 or more units of insulin per day to achieve
glycemic control and prevent ketosis2.
Mechanism: Insulin resistance occurs when cells become less responsive to
insulin, resulting in impaired glucose uptake from the blood. The pancreas
compensates by producing more insulin, leading to hyperinsulinemia.
However, this may not be enough to prevent hyperglycemia, prediabetes,
and Type 2 diabetes over time.
Associated Conditions: Insulin resistance is linked to various metabolic,
endocrine, and genetic disorders, such as obesity, cardiovascular disease,
nonalcoholic fatty liver disease, metabolic syndrome, and polycystic ovary
syndrome (PCOS).
Clinical Spectrum: there are different ways that insulin resistance can affect
people’s health. Some people may have mild symptoms, while others may have
serious complications. Related Conditions: These are some of the health problems
that can result from insulin resistance. They include:
o Obesity: This is when a person has too much body fat, which can make
insulin resistance worse.
o Glucose Intolerance: This is when a person has trouble keeping their blood
sugar levels within a normal range after eating. This can lead to prediabetes
or diabetes.
o Type 2 Diabetes: This is a chronic disease where the body either does not
make enough insulin or does not use it properly. This causes high blood sugar
levels, which can damage various organs and tissues.
o Metabolic Syndrome: This is a combination of risk factors that increase the
chance of developing heart disease, stroke, and diabetes. These risk factors
include high blood pressure, high cholesterol, high triglycerides, and
abdominal obesity.
o Extreme Insulin-Resistant States: These are rare cases where a
person has very severe insulin resistance, requiring very high doses
of insulin to control their blood sugar levels. This can be caused by
genetic defects, autoimmune diseases, or medications.
The metabolic syndrome —a state of insulin-resistance that is also known as
either syndrome X or the dysmetabolic syndrome—has drawn the greatest
attention because of its public health importance.
Metabolic Syndrome: What You Need to Know
What is metabolic syndrome? Metabolic syndrome is a condition that involves
several health problems related to insulin resistance, such as high blood pressure,
high blood sugar, high triglycerides, low HDL-C, and belly fat. It increases the risk of
heart disease, diabetes, fatty liver, and some cancers.
What are the signs and symptoms? Some of the signs and symptoms of
metabolic syndrome are:
o High blood pressure
o High blood sugar
o High triglycerides
o Low HDL-C
o Belly fat
o Chest pain or shortness of breath (indicating possible heart problems)
o Skin changes, hair growth, nerve damage, or eye problems (in some cases of
insulin resistance or diabetes)
o Yellowish patches on the skin or eyelids (in some cases of high cholesterol)
How is it diagnosed? To diagnose metabolic syndrome, doctors use the following
criteria from the NHLBI and the AHA:
o High blood sugar: Fasting glucose ≥100 mg/dL or taking medication for high
blood sugar
o High blood pressure: Blood pressure ≥130/85 mm Hg or taking medication for
high blood pressure
o High triglycerides: Triglycerides ≥150 mg/dL or taking medication for high
triglycerides
o Low HDL-C: HDL-C < 40 mg/dL in men or < 50 mg/dL in women or taking
medication for low HDL-C
o Belly fat: Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in
women; if Asian American, ≥90 cm (35 in) in men or ≥80 cm (32 in) in women
o A person has metabolic syndrome if they have at least 3 of these 5 conditions.
