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Insulin is a hormone produced by the pancreas which helps glucose, or blood sugar, make its way into cells throughout the body’s muscle, fat, and liver to be used for energy. Glucose is found in various amounts in different types of food. Blood sugar levels spike after you eat, prompting the pancreas to release insulin. Thereafter, insulin regulates blood sugar levels.
When the cells in your body no longer respond to insulin as they should, it impedes their ability to take glucose from the blood. As a result, glucose builds up in the blood. The pancreas goes into overdrive, producing even more insulin in response. This phenomenon is known as insulin resistance.
Insulin sensitivity is one of the most important markers of overall wellness. Insulin resistance is the hallmark of type 2 diabetes and is ultimately associated with the cascade of events that can cause metabolic syndrome, a cluster of disorders that increase the risk for stroke and heart disease, as well as premature cardiovascular-related deaths. 
Here, we take a closer look at insulin resistance to help you determine your risk and actively prevent against this serious condition. Additionally, patients who have already been diagnosed with insulin resistance will find treatment options below.
How is Insulin Resistance Diagnosed?
If the pancreas is able to produce enough insulin to combat the cells’ weakened insulin response, blood glucose levels will stay within a healthy range. Thus, while diagnosing prediabetes and type 2 diabetes is fairly straightforward, testing for insulin resistance isn’t always as simple.
Laboratory tools such as the Homeostatic Model Assessment of Insulin Resistance, or HOMA-IR score, can be used to detect insulin sensitivity. A HOMA-IR score of less than 1.0 indicates healthy insulin sensitivity, whereas a score between 1.7 and 2.4 suggests insulin resistance.
A score of 2.6 is the cutoff for prediabetes.  A series of other diagnostic tests, combined with a review of the patient’s medical history and symptoms, may also be used to help doctors diagnose insulin sensitivity.
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When the blood glucose levels are elevated but not high enough to be considered type 2 diabetes, patients are diagnosed with prediabetes. This occurs when patients have some insulin resistance or the pancreas isn’t producing enough insulin to keep blood sugar at a normal level.
Excess glucose therefore builds up in the bloodstream instead of being used by the cells, and 15-30% of people with prediabetes will be diagnosed with type 2 diabetes within 5 years. 
The good news is that with both insulin resistance and prediabetes, it’s possible to make lifestyle changes to prevent or delay diabetes and other serious health conditions. We’ll discuss insulin resistance treatments in an upcoming section, but first let’s examine the causes of insulin resistance.
What Are the Causes of Insulin Resistance?
Experts have yet to develop an exact understanding of the mechanisms behind insulin resistance and prediabetes, but a few major factors have been established as playing a role in the conditions.
Being overweight or obese, for example, is an important cause of insulin resistance. Storing excess fat around the abdomen, known as visceral fat, is an especially noteworthy contributing factor. For men, a waist measurement of 40 inches or more has been linked to insulin resistance, whereas 35 inches or more becomes concerning for women.
This is likely due to the fact that abdominal fat can produce hormones which contribute to chronic inflammation.  Inflammatory factors parallel insulin sensitivity. 
In addition, insulin resistance has been attributed to leading a sedentary lifestyle, as it’s suspected that exercise spurs bodily changes which help to maintain healthy blood sugar levels. Physical activity has been shown to decrease insulin resistance in previously sedentary adults. 
Beyond physical inactivity and having excess visceral fat, populations with certain genetic or lifestyle risk factors may face an elevated risk for developing insulin resistance.
Risk Factors of Insulin Resistance
Excess abdominal fat and lack of physical activity largely contribute to insulin resistance. Additional factors include:
With these risk factors in mind, let’s explore some of the possible symptoms of insulin resistance.
What Are the Symptoms of Insulin Resistance?
Diagnosing insulin resistance becomes further complicated by the fact that patients typically exhibit no symptoms. When the condition progresses to the point of prediabetes, patients may notice darkening of the skin in certain areas, such as the armpit or neck. Skin tags may also develop.
In some cases, patients may experience fatigue, weight gain, excessive thirst, and excessive urination. Nonetheless, these symptoms typically don’t manifest until the condition has surpassed the levels of insulin resistance and prediabetes or type 2 diabetes have developed.
The absence of symptoms can indeed complicate the ability to diagnose and treat insulin resistance. Nonetheless, whether you suspect you could be at risk for insulin resistance or you’ve already been diagnosed, the following lifestyle changes can benefit everyone.
Insulin Resistance Treatment Options
One of the most effective insulin resistance treatments is for overweight or obese patients to reach a healthy weight. This can be achieved both through diet and exercise.
Although low-fat diets were advised for weight loss in the past, experts now recommend the modernized and more effective approach of incorporating healthy fats into the diet, along with nutritionally dense yet low-calorie foods such as vegetables and lean protein.
Most importantly, minimizing intake of processed foods and increasing foods with a low glycemic index can make positive changes towards a healthier insulin sensitivity.  Glycemic index measures the ways in which the blood glucose levels are impacted by the food product. Foods such as white breads and pastas tend to have the highest glycemic index scores.
Exercising regularly can also spur weight loss, and is believed to support the metabolism which may help to control or prevent insulin resistance.  Certain types of exercise, such as high-intensity interval training (HIIT), tend to reduce visceral fat specifically. Finally, controlling any other risk factors, such as high blood pressure or cholesterol, may help to prevent the development of prediabetes or type 2 diabetes.
Insulin Sensitivity as an Indicator of Overall Wellness – In Conclusion
Without an in-depth analysis of a patient’s biomarkers, conditions such as insulin resistance can be easily overlooked. Yet, like many other precursors for serious disease, insulin resistance is most effectively addressed in its early stages. It’s therefore critical that at-risk populations, including adults over the age of 40, overweight or inactive individuals, and people with a family history of type 2 diabetes, have their insulin sensitivity routinely tested.
At Cenegenics, our clinicians remain focused on disease prevention by addressing any current warning signs while also giving patients the tools they need to optimize their health moving forward.
Through comprehensive lab work, patient-oriented treatment approaches encompassing individualized meal and exercise plans and ongoing vigilance, our specialists help patients navigate conditions such as insulin resistance and prediabetes successfully. The end result is better health and vitality, both now and into the future.
If you’re interested in discovering how Cenegenics can help you unlock the healthiest version of yourself, contact your nearest location today.
Next Steps in Understanding Insulin Resistance
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About the Contributor
Global Director of Nutrition & Exercise
Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.
This guide was produced with contributions from the following key resources:
The Cenegenics Education and Research Foundation
The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy
Jeffrey Park Leake, M.D., CPT
Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.
Todd David Greenberg, M.D., CSCS
Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.
 Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS. Textbook of Age Management Medicine: Volume 1. Leake-Greenberg Ventures, 2015. p.43
 Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS; see above.
 Pletcher, Peggy MS, RD, LD, CDE. “What’s to know about insulin resistance?” MedicalNewsToday. 17 Feb. 2017. Retrieved from URL: https://www.medicalnewstoday.com/articles/305567.php
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Insulin Resistance & Prediabetes.” Retrieved from URL: https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
 Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS; see above; p. 29.
 Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS; see above; p. 313.
 NIDDK; see above.
 Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS; see above; p. 29.
 Donson, Laura. “Insulin Resistance Symptoms, Causes, and Treatment.” VeryWell Health. 03 Jan. 2019. Retrieved from URL: https://www.verywellhealth.com/what-is-insulin-resistance-2242260
 Leake, Jeffrey Park, M.D., CPT, and Greenberg, Todd David, M.D., CSCS; see above; p. 136