Scientists and health professionals talk about the dangers of insulin resistance, prediabetes, diabetes, syndrome X, and metabolic syndrome. These terms can be confusing – until you realize they're all related to one basic problem: elevated blood sugar levels.
Someone with elevated blood sugar levels can go for years without symptoms. This is why millions of people are unaware that they are at increased risk for heart disease and a host of other complications related to insulin resistance, prediabetes, type 2 (often called adult-onset) diabetes, and metabolic syndrome.
What follows is a brief description of terms commonly used to describe various conditions related to elevated blood sugar levels.
Insulin Resistance
Insulin resistance is the inability of your cells to use insulin in the absorption of blood sugar (glucose). Insulin resistance means that glucose builds up in your blood, eventually leading to heart disease as well as numerous other health problems.
If you have insulin resistance, your muscle, fat, and liver cells do not use insulin properly. The pancreas tries to keep up with the demand for insulin by producing more. Eventually, the pancreas cannot keep up with the body's need for insulin, and excess glucose builds up in the bloodstream. Many people with insulin resistance have high levels of blood glucose and high levels of insulin circulating in their blood at the same time.
Because insulin resistance tends to run in families, scientists know that genes are partly responsible. Excess weight also contributes to insulin resistance because too much fat interferes with the muscles' ability to use insulin. Lack of exercise further reduces the muscles' ability to use insulin.
Insulin resistance is one of the most common diseases in America. One in three Americans may be insulin resistant. Many of those with insulin resistance don't even know it because people with insulin resistance usually have no symptoms. If you have a severe form of insulin resistance, you may get dark patches of skin, usually on the back of your neck. Sometimes people get a dark ring around their neck. Other possible sites for these dark patches include elbows, knees, knuckles, and armpits. This condition is called acanthosis nigricans.
Prediabetes
People with blood glucose levels that are higher than normal but not yet in the diabetic range have prediabetes. Doctors sometimes call this condition impaired fasting glucose or impaired glucose tolerance, depending on the test used to diagnose it. Prediabetes usually doesn't cause obvious symptoms. Only a blood test can accurately diagnose it.
Studies have shown that most people with prediabetes go on to develop type 2 diabetes within 10 years, unless they lose 5 to 7 percent of their body weight – about 10 to 15 pounds for someone who weighs 200 pounds. This can be easily accomplished by making modest changes in your diet and level of physical activity.
Diabetes
There are two types of diabetes. Type 2 diabetes is sometimes defined as the form of diabetes that develops when the body does not respond properly to insulin. It results from insulin resistance (a condition in which the body fails to properly use insulin), as well as from an insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.
Type 1 diabetes occurs when the pancreas makes little or no insulin at all. It results from the body's failure to produce insulin, the hormone that allows glucose to enter the cells in the body and fuel them.
Insulin resistance can also occur in people who have type 1 diabetes, especially if they are overweight.
The exact cause of diabetes is not known. Major risk factors to Type 2 diabetes are being overweight or obese and getting little or no exercise. Type 2 diabetes occurs more frequently in older people and in African Americans, Hispanics, and Native Americans. Pregnant women might develop diabetes at a more frequent rate than the rest of the population. It can be passed down through families as an inherited condition.
Metabolic Syndrome
Metabolic syndrome is a risk factor for diabetes, stroke, and heart disease. It is also called syndrome X and insulin resistance syndrome. It is not so much a specific medical condition, but rather a set of conditions. If you have three or more of the following conditions, you exhibit metabolic syndrome:
- Excess waist circumference – greater than 35 inches for women or 40 inches for men (measure at the level of your navel, stomach relaxed, not held in).
- High blood fats – fasting triglycerides of 150 mg/dL or higher.
- Low HDL levels – less than 40 for men or less than 50 for women. HDL is the "good" cholesterol.
- Moderately high blood pressure – 130/85 or higher.
- Moderately high blood sugar levels – fasting glucose of 100mg/dL or higher.
Metabolic syndrome is closely linked to insulin resistance. Many scientists believe insulin resistance leads to the conditions that make up metabolic syndrome. This could be caused by heredity, lifestyle factors, or a combination. While there isn't complete agreement on the exact components, causes, or consequences of metabolic syndrome, health experts do agree that it has severe health consequences.
You Can Do Something
Physical activity and weight loss make the body respond better to insulin. By losing weight and being more physically active, you might be able to reverse insulin resistance and avoid developing type 2 diabetes – and possibly restore blood glucose to normal levels.
The National Institutes of Health completed the Diabetes Prevention Program, a clinical trial designed to find the most effective ways of preventing type 2 diabetes in overweight people with prediabetes. Researchers found that lifestyle changes reduced the risk of diabetes by 58 percent, and helped many people with prediabetes return to normal blood glucose levels.
The main goal in treating insulin resistance and prediabetes is to help your body relearn to use insulin normally. Even moderate lifestyle changes can help:
- Lose weight – Even losing 10-15 pounds can make a big difference if you're overweight.
- Be physically active – Moderate exercise (such as brisk walking) just 30 minutes a day, five days a week will decrease your risk.
- Eat right – Follow a low-fat, low-calorie diet.
- Limit alcohol – Drink no more than one drink a day for women, two drinks a day for men.
- Don't smoke – And avoid secondhand smoke. If you smoke cigarettes or cigars or chew tobacco, take steps now to stop.
- Get regular checkups – Monitor your blood pressure, cholesterol, triglyceride, and blood glucose levels.
If you have metabolic syndrome, your doctor might recommend weight loss with diet and exercise, as well as with medication to lower your cholesterol and blood pressure levels. |
