How Do I Know If I Am Insulin Resistant?

Insulin resistance, a hallmark of diabetes and prediabetes, is characterized by intense thirst, increased urination, fatigue, dizziness and blurred vision.

Insulin is a hormone produced by the pancreas that functions in the body to help regulate blood sugar, control metabolism, and regulate cellular growth. 

Insulin resistance occurs when the body's cells become resistant to the effects of insulin. This results in a need for higher levels of insulin for the body to function properly. The pancreas attempts to compensate by producing more insulin until it can no longer produce enough to meet the body’s needs and blood sugar levels rise. 

Insulin resistance is a risk factor for diabetes and heart disease.

Most people who have insulin resistance have no symptoms and do not know they are insulin resistant. 

Signs you may have high blood sugar (hyperglycemia) that may indicate possible insulin resistance include: 

• Increased thirst
• Increased urination
• Fatigue
• Dizziness
• Blurred vision

If not treated, insulin resistance may lead to conditions such as: 

• High blood pressure (hypertension)
• Type 2 diabetes
• Hardening of the arteries (atherosclerosis) 
• High cholesterol and/or triglycerides in the blood

Causes of insulin resistance include: 

• Genetic factors 
• Certain medications 
• Metabolic syndrome 
  • Excess weight (particularly around the waist)
  • High blood pressure
  • High cholesterol and triglycerides
• Obesity/overweight with a body mass index (BMI) more than 25 kg/m2
• Pregnancy
• Infection or severe illness
• Stress
• Inactivity 
• Steroid use
• Older age
• Sleep problems, such as sleep apnea
• Smoking

Risk factors for developing insulin resistance include:

• Men with waist measurements greater than 40 inches or women with waist measurements greater than 35 inches
• Age over 40 years 
• Ethnicity: Latino, African American, Native American, or Asian American
• A history of high blood pressure, high blood triglycerides, low HDL cholesterol, arteriosclerosis (or other components of the metabolic syndrome)
• Having close family members with type 2 diabetes, high blood pressure, or arteriosclerosis
• Past gestational diabetes
• Polycystic ovarian syndrome (PCOS)
• Acanthosis nigricans

Insulin resistance is diagnosed with a patient history and a physical examination, and laboratory tests such as:

• Fasting blood glucose
• Insulin levels 

Treatment for insulin resistance involves lifestyle changes and medications. 

Lifestyle changes to treat insulin resistance include:

• Diet
  • Low glycemic index foods
• Weight loss
• Regular exercise
• Stress reduction
• Getting adequate sleep

Medications used to treat insulin resistance include:

• Metformin (Glucophage) 
• Acarbose (Precose)
• Thiazolidinediones such as pioglitazone (Actos) and rosiglitazone (Avandia)