Insulin Resistance - Metabolic Disorder of the 21st Century

Insulin resistance is a disorder of the hormonal economy that affects every age group. However, there is an increasing incidence of insulin resistance in people with this disorder, especially in the pro-creative age with co-existing obesity and obesity, but not only in those with normal body weight but also with disorders in body structure. There are known factors that influence the development of insulin resistance, some of which are modifiable, so it is worth taking care of an appropriate lifestyle to prevent insulin resistance or slow down its progression. The sooner appropriate measures are taken, the less will the tissue resistance to insulin worsen and one can avoid diabetes and its complications in the future. Insulin resistance is a metabolic disorder caused by a reduced sensitivity of tissues (muscle, fat tissue) or hepatocytes (liver cells) to insulin produced by the beta cells of the pancreas, which in turn can lead to abnormal levels of glucose and insulin. Insulin resistance precedes the onset of type 2 diabetes and can contribute to the development of other diseases such as hypertension and cardiovascular disease. Studies have shown that a reduced insulin sensitivity occurs more than 10 years before the onset of type 2 diabetes (J.H. Warram et al. 1990). Initially, insulin resistance can be asymptomatic, but over time, various symptoms may appear. Symptoms of insulin resistance: - depression, - irritability, - memory and concentration problems, - drowsiness (especially after a meal), - chronic fatigue, - headaches, - joint pain, - feeling cold, - increased appetite for sweets, - frequent feeling of hunger - 2-3 hours after a meal, - difficulty losing weight, - skin changes (brown spots on the skin, e.g. on the neck, on the elbow bends). Long-term insulin resistance can lead to the development of the metabolic syndrome, i.e. the simultaneous presence of diabetes, lipid metabolism disorders, hypertension and visceral obesity. The diagnosis of insulin resistance is based on: - medical history (collection of information about symptoms and their evaluation), - positive family history (increased risk if insulin resistance or diabetes is present in the family), - the so-called glucose curve and insulin curve - simultaneous measurements of glucose and insulin levels at several time points - usually fasting, after 1 hour and after 2 hours from an oral glucose tolerance test, i.e. after drinking a solution of 75 g glucose, - the HOMA-IR index, calculated on the basis of fasting glucose and insulin levels: HOMA-IR = fasting insulinemia (mU/ml) × fasting glucose concentration (mmol/l) ÷ 22.5. Under physiological conditions, the HOMA-IR index is 1. The index value at which insulin resistance is diagnosed is controversial, but most specialists believe that it is a value above 2.