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insulin resistance
Jun 13, 2003

Everyone lately is talking about this "insulin resistance", could you please expain to me what exactly it is, who gets it, what are the symptoms and what to do about it.

Thanks.

Response from Ms. Fields-Gardner

Insulin resistance is when your body is making enough insulin but your body isn't using it effectively. Not everyone gets this, but chronic infection (such as HIV) does add to risk. In addition, some medications have a side effect of causing insulin resistance (side effects don't happen to everyone who takes a drug, but it is a risk). Alcohol consumption, smoking, overweight, and other things can increase risk for insulin resistance. Generally the form of insulin resistance doesn't always have an "early warning system" of symptoms. You can ask your health care providers to evaluate your risk factors and keep an eye out for signs of problems. Physical changes that result from insulin resistance are not "early" signs.

To explain what happens when your body is insulin resistant, I will attempt to describe a sample of an event here:

you eat a meal with some carbohydrate --> your gastrointestinal tract breaks down the carbs to simpler forms so that you can absorb the carbs into your blood stream --> your body (pancreas in particular) gets signals that carbs are coming in and that it needs to produce insulin to process and store those carbs (keeping the blood sugar level even) --> but, your body is "resistant" to insulin and doesn't recognize and process the carbs as well --> so your body makes more insulin (sort of overkill) to get the carbs to process --> sometimes this leads to high blood sugar, but not always; it takes a while for your body to process the carbs in this case and your insulin levels may remain high for a while because of this which can lead to other problems...

The result can be that your body doesn't store the calories normally and you can end up with more belly fat and less fat under your skin.

In this case the treatment is not more insulin (the treatment that is used when your body doesn't make enough insulin), but diet control (keeping the carbs evenly distributed so that your body doesn't overreact producing insulin), exercise (which helps to make your body more sensitive to its own insulin), and insulin sensitizing medications (such as metformin and rosiglitazone or combinations). It also helps to quit smoking and drinking alcohol...

Good luck!


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