What is insulin resistance?

Released: Wednesday, December 07, 2016

Insulin and insulin resistance. You're familiar with the terms and you likely know someone taking it or affected by it. But, do you know what it all actually means for our health?

If you live in the United States, there's a one in three chance that you have pre-diabetes, and you may not know you're at risk. Pre-diabetes, if left untreated, can lead to full-blown type 2 diabetes, a condition that roughly 1 in 10 people in Louisiana has.

Type 2 diabetes is a condition in which your body either does not make enough insulin to lower your blood sugar, or where the cells in your body are resistant to normal levels of insulin – hence, insulin resistance.

Why is insulin so important? When we eat, food triggers organs in the body to circulate enzymes that break down food. That food is broken down into sugar inside the gut that passes through the gut wall into the blood stream. To ensure that blood sugar levels in the bloodstream don't go too high, the pancreas makes a hormone called insulin. Insulin's job is to move that blood sugar (or glucose) from the blood stream to cells to give them energy.

When someone has pre-diabetes, his or her muscle, fat and liver cells don't respond normally to insulin and cannot properly absorb sugar from the blood stream. This triggers the pancreas to produce more insulin in an effort to get sugar into cells and out of the blood stream. Cells in the pancreas – called beta cells – work harder to release more insulin and keep blood sugar levels normal, but over time those cells may not be able to keep up with the body's increased need for insulin. When the body can't keep blood sugar levels within a normal range, type 2 diabetes develops.

It may take years for someone with pre-diabetes to develop type 2 diabetes; however, if left untreated pre-diabetes may eventually develop into type 2 diabetes.

"That's why it's so important to know your risk for diabetes," said Dr. Daniel Hsia, an endocrinologist and diabetes researcher at LSU's Pennington Biomedical Research Center. "If you know you are at risk for diabetes, you can tackle the problem head on with diet, medication and lifestyle changes to avoid the risky complications that may come down the road with a type 2 diabetes diagnosis—complications such as blindness, kidney failure or amputation."

Hsia recommends everyone over the age of 45 should get screened for diabetes or pre-diabetes. Other risk factors for diabetes include a family history of the disease, being overweight or sedentary, having a history of gestational diabetes, high blood pressure or being an ethnic minority.

What should you do if you suspect you are at risk for pre-diabetes or diabetes? Talk with your doctor, who can order further testing to determine your risk and who can prescribe medication or lifestyle changes to help manage your risk.

Another option if you are at risk for developing diabetes is joining a research study at Pennington Biomedical. Right now the D2d study is looking for people to help researchers learn whether taking a vitamin D supplement is helpful in preventing diabetes.

"There are theories out there about the role of vitamin D in helping to prevent diabetes, but this study should help us better understand what is happening—are people with pre-diabetes not getting enough vitamin D, or is their body not absorbing vitamin D properly?" said Hsia, who noted that researchers believe vitamin D may help support beta cells that produce insulin so that the pancreas continues to efficiently make insulin.

"Ultimately, we are looking to add more tools to our toolbox as physicians to help prevent diabetes. If we can suggest a healthier diet and more exercise, that's great, but if we can add a supplement to the diet that can lower the risk of developing diabetes even further, we could potentially help people live healthier lives and feel better," said Hsia.

If you're interested in participating in the D2d research study, call 225-763-300 or visit www.pbrc.edu/D2d.

For more information on how you can support this and other projects at LSU’s Pennington Biomedical Research Center, visit www.pbrf.org.