Insulin Resistance: The Signals Your Body Sends and How to Treat It

Constant fatigue after meals, cravings for sweet foods, weight gathering around the waist and difficulty losing it despite your best efforts - behind these complaints there is often insulin resistance. This is a disorder in which the cells respond less well to insulin, the hormone that regulates blood sugar. It can be identified early with simple tests, and with timely changes to your habits and, where necessary, medication, it can be kept under control. In this article we explain what insulin resistance is, what the symptoms are, how it is diagnosed and how it is treated.

What is insulin resistance?

Insulin is a hormone secreted by the pancreas that „unlocks“ the cells so they can take glucose (sugar) from the blood and convert it into energy. In insulin resistance the cells become less sensitive to insulin, so the pancreas has to secrete ever larger amounts of the hormone in order to maintain a normal blood sugar level. This state of raised insulin (hyperinsulinaemia) can go for years without clear symptoms, but over time it increases the risk of obesity, type 2 diabetes, polycystic ovaries and fatty liver disease.

Symptoms of insulin resistance

The symptoms are often non-specific and easily put down to stress or tiredness. Insulin resistance may be indicated by:

• Weakness and drowsiness, particularly after meals rich in carbohydrates.
• Pronounced cravings for sweet foods and frequent hunger.
• Accumulation of fat deposits around the waist and difficulty losing weight.
• „Brain fog“ - reduced concentration and a feeling of sluggishness.
• Darker, velvety changes to the skin on the neck, in the armpits or in the groin (acanthosis nigricans).
• An irregular menstrual cycle and signs of polycystic ovary syndrome (PCOS) in women.
• Increased hair loss and mood changes.

The presence of one or more of these signs does not necessarily mean that you have insulin resistance, but it is reason enough to have targeted tests.

Causes and risk factors

• A diet high in simple sugars and processed food.
• Insufficient physical activity and a largely sedentary lifestyle.
• Excess body weight, particularly fat deposits around the abdomen.
• Chronic stress and insufficient or poor quality sleep.
• Inherited predisposition and a family history of type 2 diabetes.
• Hormonal disorders, above all polycystic ovaries.

How is insulin resistance diagnosed?

The diagnosis is made on the basis of laboratory blood tests, together with an assessment of symptoms and risk factors. The tests most often used are:

• Fasting glucose and insulin - the measured values are used to calculate the HOMA-IR index, which shows the degree of insulin resistance.
• OGTT with insulin (oral glucose tolerance test) - blood sugar and insulin are monitored after glucose is taken.
• HbA1c (glycated haemoglobin) - the average blood sugar level over the previous two to three months.
• Where needed, a lipid profile, thyroid hormones and sex hormones.

Results are always interpreted by a doctor, as reference values and the plan for further monitoring are tailored to each patient individually.

The link with obesity, PCOS and the thyroid gland

Insulin resistance rarely comes alone. It is closely linked to the way hormones affect weight and metabolism, and in women it is a frequent companion of polycystic ovaries. Disorders of the thyroid gland can further slow the metabolism and make weight regulation more difficult, which is why these conditions are often investigated together.

Treating insulin resistance

The basis of treatment is a change in lifestyle habits, which in most people significantly improves the sensitivity of the cells to insulin:

• A diet with fewer simple sugars and less processed food, and more fibre, good quality protein and vegetables, with meals spaced through the day.
• Regular physical activity - a combination of aerobic exercise and strength training helps the cells use glucose more efficiently.
• Regulating body weight - losing as little as 5 to 10 per cent of body weight can noticeably improve test results.
• Good quality sleep and stress management, as these also affect blood sugar and insulin levels.
• Medication (for example metformin) - when it is needed, it is prescribed and monitored solely by a doctor.

The aim is not a short term diet but sustainable changes made under the supervision of a doctor and, where needed, a nutritionist.

When should you see an endocrinologist?

If you recognise several of the symptoms listed above, are carrying excess weight that is hard to manage, or have diabetes in the family, an examination by an endocrinologist is recommended. On the basis of your test results the doctor will assess whether insulin resistance is present and propose a plan. Read more about our examinations on the Endocrinology page, and you can book online at Miren Medic Polyclinic.

Frequently asked questions

Can insulin resistance be cured?

In many people, insulin sensitivity improves significantly through changes in diet, physical activity and weight management, and values can return to the normal range. Insulin resistance is therefore regarded as a condition that responds well to management, with regular monitoring by a doctor.

Which test shows insulin resistance?

The test most often used is the HOMA-IR index, which is calculated from fasting glucose and insulin values. In some cases the doctor will also recommend an OGTT with insulin measurement.

Does insulin resistance mean I have diabetes?

No. Insulin resistance is a condition that precedes type 2 diabetes and serves as a warning, but it does not mean that diabetes is already present. With timely measures, the risk of developing diabetes is significantly reduced.

Does insulin resistance make it harder to lose weight?

Yes, raised insulin promotes the accumulation of fat, particularly around the waist, and can make weight loss more difficult. This is why managing insulin resistance is often a key step towards successful and lasting weight loss.

This article is for information only and does not replace a medical examination. For diagnosis and treatment, please consult an endocrinologist.