Insulin Resistance: What is prediabetes?

Diabetes, Endocrinology, Medicine, What Causes Diabetes

When it comes to diabetes, it is important to understand what is insulin resistance is, it can be explained using an economy analogy.

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Insulin resistance, (also known as prediabetes) isn’t the newest rebel group in town nor is it a CrossFit training exercise. But it is important to understand what exactly insulin resistance is when it comes to diabetes.

How does pre-diabetes happen?

The main organ involved in the development of diabetes is the pancreas. This is a corn on the cob shaped gland that sits snug against the liver, right behind the stomach. The pancreas lowers blood sugar by producing a hormone called insulin. Insulin is made by very specialized cells that react to blood sugar levels. If blood sugar levels increase after eating a meal, insulin secretion rises accordingly in order to keep sugar levels steady. If blood sugar decreases due to long periods of starvation or exercise, insulin levels fall. This insulin-sugar balance system is extremely well organized, like a healthy economy. At any given moment, the perfect amount of insulin is produced to maintain blood sugar levels within the normal range: no more, no less.


No diabetes: Pancreas produces insulin

As insulin resistance develops, the same amount of insulin that previously lowered blood sugar no longer works effectively and the pancreas needs to make up for this by producing more “insulin dollars”.

 What is insulin resistance?

Insulin resistance can be explained using the economy as an example.

As prediabetes develops, the same amount of insulin that previously lowered blood sugar into the normal range, no longer works effectively. In other words, the pancreas used to spend one “insulin-dollar” to bring the blood sugar down. When insulin resistance develops, this dollar is no longer enough. The pancreas must produce 5 “insulin-dollars” to do the same job that had, before, only cost one. This is just like inflation but is called insulin resistance because the body appears to be resistant to insulin, requiring higher levels in order to have the same effect as before. In business, inflation is generally thought to be unhealthy for the economy. The same is true for insulin resistance in the body.

As prediabetes develops, the same amount of insulin that previously lowered blood sugar into the normal range, no longer works effectively.

Does pre-diabetes cause symptoms?

People cannot feel prediabetes. At first, from the outside, all appears well and the measured blood sugar level is still within normal range. Inside the body, however, the pancreas is working overtime, forced to produce many more “insulin-dollars” than what is comfortable in order to maintain sugar levels within the normal range. Before long, the pancreas reaches its maximum ability to produce more money, and the fasting blood sugar levels become elevated. Elevated fasting blood sugar, what doctors call impaired fasting glucose, may be one of the first clues the body gives about having insulin resistance.


If insulin resistance continues to advance the pancreas reaches its maximum ability to produce more “insulin dollars” and goes bankrupt. The result of this is that blood sugar rises.
Pre-diabetes is defined as a HgbA1C level between 5.7-6.4%, or a fasting glucose between 100 and 125
About the Author
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Susan Kim M.D.

Dr. Kim earned her medical degree from Rutgers Medical School. She completed residency in Internal Medicine at St. Vincent’s Hospital in New York City followed by fellowship in Diabetes, Endocrinology and Metabolism at both St. Vincent’s Hospital and NYU-Langone Medical Center.

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Last Modified: Sep 15, 2017 @ 2:54 am

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Insulin resistance: Breaking the pancreas bank
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Insulin resistance: Breaking the pancreas bank
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Insulin resistance isn’t the newest rebel group in town but it is important to understand what exactly it is when it comes to diabetes.
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