Weight and metabolism
Insulin resistance
Short answer
Insulin resistance is one of the main causes of metabolic disorders, and it can be present even when fasting blood sugar is normal. The easiest way to calculate it is the HOMA-IR index: the blood sugar (mg/dL) measured after 8–10 hours of fasting is multiplied by the fasting insulin, and the result is divided by 405. The cutoff the doctor uses is 2.5; a result above this indicates resistance. Physical activity and proper nutrition are the main tools for overcoming this problem.
A normal fasting sugar does not mean your metabolism is normal.
General information
- Example. If fasting blood sugar is 85 mg/dL (normal 60–100) and fasting insulin is 18, HOMA-IR = 85 × 18 / 405 = 3.8. This is higher than 2.5. As you can see, a normal fasting blood sugar does not mean that the metabolism is working normally.
- Symptoms:
- frequent hunger; shakiness and weakness when a meal is delayed;
- acanthosis nigricans — darkening in the skin folds;
- skin that looks like hives (nettle rash);
- sleep problems, irritability, tension;
- irregular periods in women;
- difficulty losing weight, weight gain;
- increased body fat, acne.
- What it can lead to:
- type 2 diabetes;
- polycystic ovary syndrome (PCOS) in women;
- an increase in “bad” cholesterol in the blood, and as a result cardiovascular disease and high blood pressure;
- fatty liver.
- Excess insulin (hyperinsulinemia).
- Consequences: metabolic syndrome, PCOS, infertility, hirsutism, acne, hypertension.
- Causes: mainly obesity; also damage at the receptor level, kidney or liver failure, and insulin given in a higher dose than needed.
- Treatment: diet, physical activity and, when needed, medicines that improve insulin sensitivity.
- Acanthosis nigricans.
- What it is: darkening and thickening of the skin in folds (neck, armpits, groin).
- Causes: most often insulin resistance and type 2 diabetes. Also PCOS, excess weight, hypothyroidism, hormonal diseases such as Cushing's syndrome, certain medications and, rarely, tumors.
- When to see a doctor: if the darkening starts suddenly, if it keeps spreading, or if itching, thickening or pain is added.
- Treatment: the underlying cause must be identified first. After that, medicines that improve insulin sensitivity, weight loss and special skin creams are used. In the doctor's words: “Acanthosis nigricans is not a skin problem in itself but a sign of hormonal and metabolic disorders in the body.”
- Skin tags (papillomas) (from the doctor's post).
- Small bumps on the face and neck can be an early sign of insulin resistance.
- How they form: insulin resistance comes with hyperinsulinemia. Insulin stimulates IGF-1 receptors, which increases the multiplication of skin cells (keratinocytes) and the activity of fibroblasts. This in turn causes skin tags and sometimes acanthosis nigricans.
- In the doctor's words: “These are a direct indicator of insulin resistance, and it is not right to do any procedure on them without treating it.”
In the doctor's practice
“Sometimes diseases or symptoms share a common cause. Like the problems caused by insulin resistance.” The doctor also spoke about insulin resistance, diabetes and goiter on a live Xəzər FM broadcast.
Q&A
If there is insulin resistance, will it definitely turn into diabetes?
Not necessarily. Insulin resistance is the most important risk factor for type 2 diabetes. But physical activity, proper nutrition and weight loss are the main tools for overcoming this problem. When needed, medicines that improve insulin sensitivity are added.
Can small skin tags (papillomas) be related to insulin resistance?
Yes. Such skin tags can be an indicator of insulin resistance. The cause should be treated first; it is not right to do a procedure on the skin tags without doing that.
Is acanthosis nigricans only a cosmetic problem?
No. It is a sign of a hormonal and metabolic disorder in the body. Skin creams do not work unless the cause is treated.