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Insulin Resistance Syndrome

Insulin resistance syndrome, also known as metabolic syndrome or syndrome X, affects approximately 60-75 million people in the United States. Insulin is a hormone produced by the pancreas that moves glucose from the blood stream into cells, which is used as fuel for the body. It also stimulates the liver and muscle cells to absorb glucose and store it as glycogen. Insulin resistance is a condition that results when the normal levels of insulin are too insufficient to move glucose into the cells, causing the cells to be resistant to the function of insulin. To try to overcome the effect, the pancreas increases production of insulin to attempt to maintain normal glucose use and levels in the blood. Over time, the pancreas fails and insulin resistance can lead to type 2 diabetes mellitus. Although exact causes of the condition are undetermined, excess weight and minimal or no exercise contribute to the condition. There may also be genetic factors including family history of diabetes, heart disease and hypertension. People who are thin or obese can carry the condition, so weight is only one possible factor. Other factors may include ethnicity, hormones, steroid use, medications, sleep problems, older ages, certain diseases and smoking.

What are the symptoms of insulin resistance?
Unfortunately, there are no definitive symptoms of insulin resistance. However, elevated blood pressure, increased fasting glucose levels, large waist circumferences (men larger than 40 inches, and women larger than 35 inches), low HDL cholesterol and high triglyceride levels are often seen with the syndrome. In severe cases of insulin resistance, one may develop dark patches of skin, especially around the neck, elbows, knees, knuckles and armpits.

Who should be tested for insulin resistance?

  • All adults over 45
  • Those who are overweight or obese at any age large waist circumference or a body mass index over of 26 or higher
  • Those who have a parent or sibling with diabetes
  • People who are physically inactive
  • Those with a family history of diabetes - African Americans, Native Americans, Asian Americans and Pacific Islander Americans have the highest risk
  • People who have a baby over 9 pounds in weight
  • Those with a previous diagnosis of gestational diabetes
  • People with polycystic ovarian syndrome which is now believed to be a component of insulin resistance
  • Those with hypertension
  • Those with cardiovascular disease
  • Those with low HDL cholesterol

If initial testing is normal, blood tests need to be repeated every two to three years. The tests available include serum insulin level, combined with a fasting plasma glucose test.

How can insulin resistance be treated?

  • Physical activity a walking program of 30 minutes a day for five days each week
  • Diet adjustments lowering intake of fats and calories with a controlled diet such as the Mediterranean diet or diabetic diet have been helpful
  • Vitamin D the Institute of Medicine recommends supplementation of at least 800 IU of vitamin D daily
  • Quit smoking
  • The FDA has not approved any drug specifically for insulin resistance therapy, but medications such as Metformin (Glucophage) have been used to control glucose levels and thereby restore the response to insulin. Studies now show that it is not as effective as losing weight and exercise.
  • Coenzyme Q10 an antioxidant that prevents utilization of LDL cholesterol and energizes the cells of the heart 90-120 mg/day.
  • Alpha-lipoic acid an antioxidant that improves cell responsiveness to insulin and helps stabilize blood sugar 100-400 mg/day.
  • Chromium a mineral that stabilizes blood sugar and burns fat 1000 mcg/day.
  • Magnesium low Magnesium levels in patient is often present with high glucose levels and high insulin. Oral Magnesium has been shown to improve insulin resistance 100-400 mg/day.
  • Berberine a Chinese medication used to decrease blood glucose levels.

If you are fit in to any of the categories listed above, talk to your physician about being screened. Take action and try to improve you health.

More about Dr. Aulds

Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.

Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.

Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.