Disclaimer: The following article is for informational purposes only and not meant to be diagnostic. Please consult your healthcare provider for medical advice.
What Is Insulin Resistance?
Like a key to open the lock, there is insulin to initiate the human metabolism.
There is a lot of discussion over diabetes and its consequences; let us now understand the concept of ‘Insulin resistance,’ which is also considered a prequel stage for diabetes.
Insulin is the most precious hormone that fetches energy to our cells.
When insulin is dysregulated, a metabolic imbalance exists in the body's physiological functions.
Insulin resistance is a pathophysiological disorder wherein the insulin receptors are impaired at various target cells, which lack access to the hormone. This increases serum insulin in a compensatory role along with elevated glucose in the blood.
In short, insulin resistance disturbs your cell routine of making energy at various target tissue sites, leading to metabolic dysregulation like fatty liver, obesity, and protein breakdown.
It is also a reason for failed immunity and increased triglycerides, further leading to obesity, inflammation, and type 2 diabetes.
Is Insulin Resistance The Same As Diabetes?
Although Insulin resistance (IR) shows symptoms similar to diabetes, the two have different etiology.
Insulin insufficiency exists in diabetic conditions, and during insulin resistance, the body resists accepting insulin for further anabolic regulation.
However, it is always observed that insulin resistance gradually increases the risk of type 2 diabetes.
Insulin resistance is not diabetes; however, chronic insulin resistance will lead to diabetes in the long run, and hence, it is also termed pre-diabetes.
Both insulin resistance and diabetes will induce macro and microvascular diseases, non-alcoholic fatty liver disease, polycystic ovarian syndrome, and hypertension.
There are three types of Insulin resistance:
Type A IR – Reduced number and dysfunction of insulin receptors.
Type B IR – Anti-bodies produced against insulin receptors.
Type C IR – Post receptor defect.
Each type responds to treatment differently, carrying various other risks.
For example, type A is inherited; type B patients find it harder to respond to treatments and have an increased rate of mortality. (Hong et al., 2018)
What Causes Insulin Resistance?
The root causes of insulin resistance are many, including being inactive, having unhealthy eating habits, excessive calorie consumption, genetic factors, stress, obesity, and inflammation.
Lifestyle problems like irregular circadian rhythms, binge eating, excessive carbohydrate and fat consumption, lack of protein, and stress might disturb metabolism.
Hyperplasia and hypertrophy of the fat cells, the release of androgens irregulated hormones, and lack of physical activity lead to visceral fat, obesity, and insulin resistance. (Hardy et al., 2012)
Nonetheless, not all obese people suffer from insulin resistance, and this is determined by their genetic predisposition and the role of their adiponectin, which we will be discussing further.
In obesity, an increase in adipocytes rings the bell in the body to release inflammatory cytokines like Interlukein-6 (IL-6) and others only to suppress the expression of genes like GLUT-4 transporter.
IL-6 induces muscle insulin resistance and lowers the expression of GLUT-4 and IRS 1 & 2 by upregulating TLR-4 (transmembrane protein) and STAT-3 (transcription factor).
This is the pathogenesis of how insulin resistance can be triggered. There can be various probabilities for triggering a disease, like genes, epigenetics, nutrition, and stress.
Insulin Resistance- Genetic & Epigenetic Factors
A million-dollar question about most diseases revolves around family history concerning morbidity and mortality.
Health experts call it ‘Genes,’ many scientists are still focused on genetic research.
Meanwhile, ‘Epigenetics’ has made a predominant mark in research by successfully investigating the probabilities of various influences on gene expression.
Insulin resistance is also said to be genetically pre-disposed from parents and family, as we discussed above concerning the genetic factors (hereditary) and adiponectin, the hormone adipocytes release to regulate metabolism. (Vaag, 2008)
So, when there are decreased levels of adiponectin running in the family, there is a risk of metabolic disorders like insulin resistance, type 2 diabetes, atherosclerosis, obesity, etc, despite having a healthy BMI.
Having this in mind, do not forget that epigenetic factors play a huge role in metabolic regulations.
But what are epigenetic factors?
Scientifically, epigenetic markers are known as
These factors are highly dysregulated with epigenetic influences in several infectious diseases and can help regulate crucial cellular processes like cell division, cell migration, DNA damage repair, and apoptosis.
Epigenetics studies the external influences on your gene expression.
External influences can be your diet, habits, alcohol, smoking, drugs, medication, stress, inflammation, obesity, and other co-morbid conditions. (Klimczak & Śliwińska, 2024)
Lifestyle and habits do not alter gene sequencing but have a huge role in gene expression.
For example, how your body responds to chronic stress becomes an epigenetic factor that can alter your gene expression and pave the way to switch on or off a gene.
Hypermethylation or hypomethylation can decrease or increase the risk of cancer and other disorders. (Bonetta, 2008)
Am I Insulin-Resistant?
How do you know if you are insulin-resistant?
- You might feel fatigued.
- You might have elevated blood sugar.
- You may gain weight and have a waistline over 35 inches in women and 40 inches in men.
- You will lose your muscles.
- You may have visceral fat stores.
- You suffer from low immunity.
- Excessive hunger and thirst.
- Frequent urination, headaches.
Watch out for these symptoms and get them addressed as soon as possible.
Is Insulin Resistance Reversible?
The treatment depends on how extreme the insulin resistance is and what the other health conditions are.
However, the primary interventions have been consistent healthy health practices and lifestyle changes that help prevent epigenetic gene expression triggers.
It can only reverse or delay type 2 DM with consistent health practices and temporary medical support. (Insulin Resistance & Prediabetes - NIDDK, n.d.)
How Do I Cope And Prevent Further Damage?
As we discuss consistent health practices, let us focus on and elaborate on them.
- Diet: It is a good habit to maintain a balanced diet; however, when obesity, triglycerides, and diabetes run in the family, one must give special attention to what is put on one's plate. A low carbohydrate, low fats, and high protein diet is recommended with increased hydration and needed supplementation concerning any deficiencies.
- Sleep-wake cycle: Maintaining a strict circadian rhythm is the key to good health, especially regarding hormones and adrenaline. Sleeping on time with reduced screen time and darkness will release melatonin that aids in quality sleep. Increased screen time, screen time before bedtime, snacking before bedtime, and staying awake till late at night will disturb the circadian rhythm.
- Physical activity: Physical activity is necessary for all ages, from children to adults. Spending an hour doing physical chores and another 30 minutes for any exercise will keep the BMR in shape, decreasing the risks of obesity and inflammation.
- Stress and hormones: Abstinence of all the above lifestyle changes will only increase your risk of stressful thoughts and dopamine dysfunction. One must always stay engaged in cognitive and physical activities to avoid stress. It is also advisable to keep alcohol consumption reserved for only special occasions and completely abstain from tobacco.
Takeaway
It may be said that if you are someone facing weight gain issues, you have a history of many hospital admissions running in your family if you are someone who lacks a proper schedule for diet, exercise, and sleep.
Suppose you are someone with stress and anxiety issues, with the above information in mind.
In that case, you can reduce or delay the risk of altered gene expression leading to insulin resistance, type 2 diabetes, and other chronic diseases.
References
Bonetta, L. (2008). Epigenomics: Detailed analysis. Nature, 454(7205), 795–798. https://doi.org/10.1038/454795A
Hardy, O. T., Czech, M. P., & Corvera, S. (2012). What causes the insulin resistance underlying obesity? Current Opinion in Endocrinology, Diabetes, and Obesity, 19(2), 81. https://doi.org/10.1097/MED.0B013E3283514E13
Hong, J. H., Kim, H. J., Park, K. S., & Ku, B. J. (2018). Paradigm shift in the management of type B insulin resistance. Annals of Translational Medicine, 6(Suppl 2), S98–S98. https://doi.org/10.21037/ATM.2018.11.21
Insulin Resistance & Prediabetes - NIDDK. (n.d.). Retrieved February 6, 2024, from https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
Klimczak, S., & Śliwińska, A. (2024). Epigenetic regulation of inflammation in insulin resistance. Seminars in Cell & Developmental Biology, 154, 185–192. https://doi.org/10.1016/J.SEMCDB.2022.09.004
Vaag, A. (2008). To be predisposed to insulin resistance and type 2 diabetes. The Journal of Physiology, 586(Pt 10), 2421. https://doi.org/10.1113/JPHYSIOL.2008.154856
