Insulin Resistance
Insulin resistance means the body's cells do not respond normally to insulin, so the pancreas must secrete more to keep blood sugar controlled. Over time, this compensatory mechanism fails, leading to prediabetes or type 2 diabetes. Insulin resistance is also central to metabolic syndrome, PCOS, non-alcoholic fatty liver disease, and cardiovascular risk.
Symptoms
Fatigue especially after carbohydrate-rich meals, difficulty losing weight despite caloric restriction, cravings for sugar or starch, brain fog, acanthosis nigricans (dark velvety skin in body folds), skin tags, and irregular menstrual cycles in women.
Causes and risk
Visceral adiposity is the strongest modifiable risk factor. Other contributors include physical inactivity, poor sleep quality, chronic stress, high-fructose diet, smoking, and genetic predisposition. Certain medications (corticosteroids, antipsychotics) can worsen insulin sensitivity.
How it is evaluated
We assess fasting glucose, fasting insulin, and calculate the HOMA-IR index. A1C, lipid panel, and liver enzymes complete the metabolic picture. In women we screen for PCOS markers.
Treatment
Weight loss of 5 -- 10% significantly improves insulin sensitivity. Low-glycemic nutrition, resistance training, and improved sleep duration are first-line. Metformin reduces hepatic glucose output and can lower fasting insulin. GLP-1 agonists address insulin resistance alongside weight loss. Myo-inositol is used adjunctively in PCOS.