Insulin Resistance

Insulin resistance (IR) is not diabetes, but a state of impaired metabolism. In this condition, the body’s cells (primarily muscle, fat, and liver cells) become “deaf” or resistant to the action of the hormone insulin. The pancreas responds by producing even more insulin (hyperinsulinemia) to force the cells to take in glucose. Initially, blood sugar levels remain normal, but insulin levels are dangerously high.

Causes and risk factors

• Insulin resistance is often called a “disease of civilization.” The main causes include:
• Visceral obesity: Accumulation of fat around abdominal organs.
• Excessive consumption of sugar and processed foods: Frequent blood sugar spikes “exhaust” cellular receptors.
• Physical inactivity: The muscles are the largest consumers of glucose; when they don’t work, their sensitivity decreases.
• Chronic stress and lack of sleep: High cortisol levels directly block the action of insulin.
• Polycystic ovary syndrome (PCOS): IR is common in women with hormonal imbalances.

Symptoms – how to recognize it?

Insulin resistance does not cause specific pain, but it has clear metabolic markers:

• Difficulty losing weight: Especially in the waist and abdominal area (“insulin belly”).
• Constant craving for sweets: Intense hunger shortly after eating.
• Afternoon fatigue: Severe drowsiness after lunch.
• Acanthosis Nigricans: Darkening of the skin in fold areas (neck, armpits).
• Difficulty concentrating: So-called “brain fog.”

Diagnosis and “HOMA index”

People often ask, “What tests are done for insulin resistance?” Standard fasting blood sugar tests are often insufficient. The following are needed:

• Fasting insulin (IRI): Blood sugar is often normal, but insulin is outside normal ranges.
• HOMA-IR index: A mathematical ratio between fasting glucose and insulin. Values above 2.5 usually indicate resistance.
• OGTT with triple insulin measurement: Testing insulin levels at the 0, 60th, and 120th minute after glucose intake (the most accurate method).

Treatment and lifestyle changes

The good news is that insulin resistance can be managed and even completely reversed:

• Low glycemic index diet: Avoid sugar, white flour, and sweetened beverages. Focus on fiber, protein, and healthy fats.
• Intermittent fasting: Allows insulin levels to drop.
• Strength training: Increasing muscle mass is the most effective way to improve insulin sensitivity.
• Medications: In some cases, doctors prescribe metformin (medications like Glucophage or Siofor) to support the process.

Synonyms: Prediabetic condition, Hyperinsulinemia