Your Good Health: Narrowing down main cause behind insulin resistance

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A great deal of work has been done trying to elicit why people develop resistance to insulin.

Dear Dr. Roach: What is the main cause for insulin resistance? I was diagnosed with Type 2 diabetes about five years ago. I’ve maintained a consistent weight under 200 pounds, and I’m only 5 feet, 9 inches tall. I was able to get my A1C level to 7.2% last summer, but in late fall, my numbers started spiking, even with insulin. I now find myself injecting crazy amounts of insulin just to maintain normal glucose levels.

There are some rare congenital cases, involving mutations of the insulin receptor. There are also rarely acquired immune-mediated causes that have antibodies to insulin or the insulin receptor and have an extremely high resistance to insulin. People with abdominal obesity and insulin resistance often have abnormal cholesterol levels and high blood pressures, a combination called “metabolic syndrome.” Blood pressure and cholesterol must often be treated independently.

Some medicines can cause insulin resistance. Critically, glucose itself can cause insulin resistance! High blood sugar levels prevent insulin release as well. That’s why getting and keeping a normal blood sugar level is so critically important, especially when a person is first diagnosed.

 

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