Type 2 Diabetes 101: Part B

By: Sheila Kun RN, BSN, MS, CPN, FCCP

Last week we reviewed the role of insulin in the regulation of blood glucose. This week we enter into another important concept in the management of diabetes – what is insulin resistance?

What is insulin resistance?

Insulin resistance is a condition in which the body produces insulin but does not use it effectively. The body produces insulin, but the cells in the body fail to respond to the normal actions of the hormone insulin (through changes in their surface receptors) and are unable to use it as effectively. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells, leading to type 2 diabetes or prediabetes.

Most people with insulin resistance don’t know they have it for many years – until they develop type 2 diabetes, a serious, lifelong disease. The good news is that if people learn they have insulin resistance early on, they can often prevent or delay diabetes by making changes to their lifestyle. Insulin resistance can lead to a variety of serious health disorders.

What happens with insulin resistance?

In insulin resistance, muscle, fat, and liver cells do not respond properly to insulin and thus cannot easily absorb glucose from the bloodstream. As a result, the body needs higher levels of insulin to help glucose enter cells.

The beta cells in the pancreas try to keep up with the increased demand for insulin by producing more. As long as the beta cells are able to produce enough insulin to overcome the insulin resistance, blood glucose levels stay in the healthy range.

Over time, insulin resistance can lead to type 2 diabetes and pre-diabetes because the beta cells fail to keep up with the body’s increased need for insulin. Without enough insulin, excess glucose builds up in the bloodstream, leading to diabetes, prediabetes, and other serious health disorders.

What causes insulin resistance?

Although the exact causes of insulin resistance are not completely understood, scientists think the major contributors to insulin resistance are excess weight and physical inactivity.

Excess Weight

Some experts believe obesity, especially excess fat around the waist, is a primary cause of insulin resistance. Studies have shown that belly fat produces hormones and other substances than can cause serious health problems such as insulin resistance, high blood pressure, imbalanced cholesterol, and cardiovascular disease. Belly fat plays a part in developing chronic, or long-lasting, inflammation in the body. Chronic inflammation can damage the body over time, without any signs or symptoms.

Physical Inactivity

In the body, more glucose is used by muscle than other tissues. Normally, active muscles burn their stored glucose for energy and refill their reserves with glucose taken from the bloodstream, keeping blood glucose levels in balance.

Studies show that after exercising, muscles become more sensitive to insulin, reversing insulin resistance and lowering blood glucose levels. Exercise also helps muscles absorb more glucose without the need for insulin. The more muscle a body has, the more glucose it can burn to control blood glucose levels.

Next week we will explore the early and late symptoms when excessive glucose (hyperglycemia) builds up overtime in your blood stream.

Your homework from the Care Ministry this week: explain to a friend what causes insulin resistance.

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