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Ask the Doctors: Insulin resistance can be helped with diet, exercise

People often don’t know they have this condition until a routine blood test reveals it. It can put you at risk for Type 2 diabetes.

Insulin resistance is a warning sign that you’re at increased risk of developing Type 2 diabetes.
Insulin resistance can lead to chronic elevated blood sugar, a warning sign that you’re at increased risk of developing Type 2 diabetes.
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Dear Doctors: My yearly physical showed I have insulin resistance. My doctor says I should stop eating sugar and exercise more. Is that going to be enough to make this go away?

Answer: When someone has insulin resistance, it means their body is no longer efficient at accessing the sugars in the blood — glucose — to use for energy.

This leaves cells short on fuel and creates a chronic surplus of blood sugar, which can lead to a range of health problems.

Glucose is a simple sugar that’s a product of digestion and is the main source of fuel for your cells. It travels through the blood, which is why it’s called blood sugar.

But it isn’t immediately available to cells. That’s where insulin, a hormone manufactured by the pancreas, comes in. Insulin helps transport glucose from the blood into cells, where it can be used.

Insulin resistance means the cells of the muscles, fat and liver have stopped responding well to the presence of insulin. They’ve become sluggish in accepting enough glucose from the blood.

This prompts the pancreas to release additional insulin to help things along.

Over time, the insulin-producing cells of the pancreas aren’t able to keep up with the insulin needed. This causes a gradual increase in blood-sugar levels.

Chronic elevated blood sugar puts people at risk of cardiovascular disease and can damage the nerves, kidney and eyes.

Insulin resistance is a silent condition. People typically find out about it as you did — when routine blood tests reveal elevated blood sugar.

Physical signs that someone may have developed insulin resistance include blood pressure readings of 130/80 or above, a large waistline or the presence of belly fat.

Some people experience increased thirst, increased urination, general fatigue and persistent hunger even after eating. People who are older, sedentary and overweight are more likely to develop the condition.

Once diagnosed, daily exercise is very effective because it provides an alternative route for moving glucose into the muscles without the help of insulin.

Avoid added sugar, which puts a burden on the pancreas, and focus on healthful proteins and fats, beans, legumes, fresh vegetables, fruit and leafy greens.

Reaching a healthy weight is also important.

Insulin resistance is a warning that you’re at increased risk of developing Type 2 diabetes. Take this diagnosis seriously, and follow your doctor’s recommendations.

Drs. Eve Glazier and Elizabeth Ko are internists at UCLA Health.