What are the signs and symptoms of insulin resistance?

Some people with insulin resistance have telltale signs, such as [1,2]:

• a darkening of the skin around the armpits or the neck, known as acanthosis nigricans

• small cutaneous (skin-related) growths called skin tags or other cutaneous abnormalities

• an enlarged waistline (“apple shape”)

If the situation has become more severe and you’ve progressed into hyperglycemia (high blood sugar), you may feel tired and thirsty while also needing to urinate frequently, or hungry even though you've already eaten [3].

Insulin resistance may have unusual or surprising warning signs that aren’t as obvious, including:

• Hair loss, due to high levels of glucose in your blood changes your hair’s growth cycle and triggers inflammation that impedes blood flow to your hair follicles.

• Sugar cravings are due to a vicious cycle where your body’s glucose is dysregulated and you begin to crave sweet things to bring your glucose levels back to normal after crashing.

• Lethargy and fatigue, due to your cells being starved of glucose and unable to properly make use of it.

The reality is that most people with insulin resistance don’t experience any noticeable symptoms, which makes it all the more important to see your doctor for routine bloodwork and lead a balanced, metabolically healthy lifestyle.

What is insulin resistance?

Insulin resistance is a metabolic condition brought about by factors such as a diet high in processed, high-carbohydrate foods; a sedentary lifestyle; excess body fat; genetics; and some hormonal syndromes like polycystic ovarian syndrome (PCOS) [4].

If left unchecked, it can progress to pre-diabetes, in which blood sugar levels are higher than normal, and then on to Type 2 diabetes, metabolic syndrome, nonalcoholic fatty liver disease, and other cardiovascular problems[5-7].

How do you test for insulin resistance?

The best way to tell if you’ve developed insulin resistance is by getting your blood glucose tested at your doctor’s office. Sometimes your doctor will test for glucose intolerance or pre-diabetes instead.

The three most common tests for this are:

1. A fasting plasma glucose test, which measures your glucose levels after 8 hours of not eating or drinking.

2. An oral glucose tolerance test, in which you’ll take a fasting plasma glucose test, drink a special solution of glucose, and then get your blood glucose levels measured after 2 hours.

3. A haemoglobin A1C test, which provides a snapshot of your average blood glucose for the past 2-3 months.

How do you reverse insulin resistance?

1. Eat a metabolically healthy diet

2. Exercise regularly

3. Get better sleep

4. Manage stress levels

5. Stick to a healthy weight

How can a CGM (continuous glucose monitoring) help with insulin resistance?

If the two key steps to reversing insulin resistance are improving your insulin sensitivity and balancing your glucose levels, continuous glucose monitors (CGMs) are a powerful tool to help you track your glucose levels. Monitoring your blood sugar levels with a CGM can provide you with a wide array of insights that help inform specific and long-term lifestyle changes, many of which can improve your insulin sensitivity.

Not only can you learn to identify the foods that trigger glucose spikes, but you can understand how your specific responses to exercise timing, sleep patterns, and periods of stress or inactivity are contributing to your glucose levels (and, by proxy, your insulin response).

More importantly, CGMs can empower you with the knowledge you need to combat insulin resistance before it develops into a more serious chronic condition like Type 2 diabetes or metabolic syndrome. Since the symptoms of metabolic disarray often don’t appear until it’s too late, many people with insulin resistance don’t even know they have it.

References:

1. https://pubmed.ncbi.nlm.nih.gov/31261473/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106409/

3. https://www.cdc.gov/diabetes/managing/manage-blood-sugar.html

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1204764/

5. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance

6. https://www.cdc.gov/diabetes/basics/type2.html

7. https://www.ncbi.nlm.nih.gov/books/NBK507839/