What is Insulin Resistance?
When you eat food, your blood sugar spikes, stimulating your pancreas to release insulin that escorts the sugar from your blood into your cells to be used as fuel or stored as fat.
Insulin resistance occurs when cells in your muscles, fat, and liver don’t respond well to insulin and can’t easily accept the glucose from your blood. As a result, your pancreas has to make more insulin to help the glucose enter your cells. Over time, the pancreas will not be able to keep up, resulting in chronically high blood sugar, which is the definition of diabetes. It is this combination of insulin resistance and pancreatic cell failure that leads to type 2 diabetes.
Research shows that the most likely cause of insulin resistance is an accumulation of microscopic fat particles within muscle and liver cells from chicken fat, beef fat, cheese fat, fish fat, and even vegetable fat in the food we eat.
Insulin resistance and prediabetes usually have no symptoms and most people with prediabetes have it for years without knowing it.
What is Prediabetes?
Prediabetes is a category of increased risk for developing type 2 diabetes. With prediabetes, blood glucose levels are higher than normal, but not high enough to be diagnosed with diabetes.
Approximately one in three American adults can be classified as having prediabetes right now. Of those with prediabetes, more than 80% don’t know they have it. If you have prediabetes, you also have insulin resistance and the cells in your body don’t respond normally to insulin.
Insulin resistance and prediabetes usually have no symptoms and most people with prediabetes have it for years without knowing it.
Risk factors for prediabetes include being overweight, 45 years or older, having a parent, brother, or sister with type 2 diabetes, and being physically active less than 3 times a week. Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.
How are Prediabetes and Diabetes Diagnosed?
There are several blood tests that help doctors determine if you have prediabetes or diabetes.
One-time blood sugar test, either random or fasting
A random, or non-fasting test, will determine your t to see what your blood sugar is at a given point during the day. A normal random blood sugar level is between 70 and 140 mg/dL.
A fasting blood sugar test is a blood test done after not eating or drinking for 8 to 12 hours (usually overnight). A normal fasting blood sugar level is less than 100 mg/dL.
Hemoglobin A1C
A Hemoglobin A1C, or A1C for short, is a blood test that measures your average blood sugar level over the past two to three months. As one of the commonly used tests to diagnose prediabetes and diabetes, your A1C is also the main test your health care team uses to manage your diabetes.
What Does the A1C Test Measure?
When sugar enters your bloodstream, it attaches to hemoglobin, a protein in your red blood cells. Everybody has some sugar attached to their hemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin.
Who Should Get an A1C Test, and When?
Adults over age 45, or under 45 and overweight, who have one or more risk factors for prediabetes or type 2 diabetes should get a baseline A1C test.
Risk factors for prediabetes and type 2 diabetes include:
- Having a parent, brother, or sister with type 2 diabetes
- Physical activity less than 3 times a week
- Being of certain ethnic groups, including African American, Hispanic/Latino American, American Indian, Pacific Islander, and some Asian American groups
Diagnosing Prediabetes or Diabetes with Hemoglobin A1C
- Normal = Below 5.7%
- Prediabetes = 5.7% to 6.4%
- Diabetes = 6.5% or above
Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.
Although the rate of progression varies, approximately 25% of people with either impaired fasting glucose or impaired glucose tolerance will go on to develop type 2 diabetes over three to five years.
Can I Prevent or Reverse Insulin Resistance and Prediabetes?
Researchers don’t fully understand what causes insulin resistance and prediabetes, but they think excess weight and lack of physical activity are major factors.
Excess weight
Experts believe obesity, especially abdominal fat and visceral fat, or fat around the liver, stomach, and pancreas, is a main cause of insulin resistance. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance. Research also shows that belly fat makes hormones and other substances that can contribute to chronic, long-lasting inflammation in the body. Inflammation may play a role in insulin resistance, type 2 diabetes, and cardiovascular disease.
Physical inactivity
Not getting enough physical activity is linked to insulin resistance and prediabetes. Regular physical activity causes changes in your body that keep your cells sensitive to insulin and better able to keep your blood glucose levels in balance. Studies show that a 5-7% weight loss, which is 10-14 pounds for a person weighing 200 pounds, will make a significant difference in reducing the chance of developing diabetes.
The Bottom Line:
If your one-time blood sugar level or hemoglobin A1C are above ideal levels, you’re far from alone. Many Americans are overweight or obese and have bigger-than-healthy bellies, both risk factors for developing insulin resistance, prediabetes, and eventually type 2 diabetes. Excess weight and waist circumference also affect blood pressure, LDL cholesterol, and triglycerides
Discovering your blood sugar numbers is the first step. As with all disease management, focusing on healthy diet choices and daily activity will likely improve your symptoms and disease progression.
