Difference Between Insulin Resistance and Diabetes


Insulin resistance occurs when insulin is produced by the body but not used effectively by the cells.

Insulin is a hormone that allows cells throughout the body, particularly in the liver and in the muscles, to absorb glucose and use it to create energy. Insulin resistance interferes with that absorption and can lead to the development of pre-diabetes or type 2 diabetes.

How Insulin Resistance Develops

Insulin resistance has a strong genetic factor. Native Americans, African Americans, Hispanic Americans, Asian Americans and Pacific Islanders are all at increased risk for developing insulin resistance. Ultimately, this is likely to lead to type 2 diabetes for these populations. A family history of type 2 diabetes is also an indicator of a higher risk of developing insulin resistance.

Certain medications can contribute to insulin resistance, including a number of drugs used to treat bipolar disorder (Zyprexa, Depakote, clozaril, Seroquel and Risperdal) as well as certain steroids.

Metabolic syndrome, a group of disorders including excess weight (particularly around the middle), high blood pressure, and elevated blood lipid levels can also cause insulin resistance.

Pregnancy, stress, infection, untreated sleep apnea or severe illnesses are other risk factors for developing insulin resistance.

How Insulin Resistance and Diabetes Differ

There is considerable overlap in the diagnoses of insulin resistance and diabetes, but they are not the same disease. With insulin resistance, the body continues to produce insulin. In fact, as the muscle, fat and liver cells begin not to take in the insulin produced, the body increases its production of insulin in an attempt to get these cells to accept the glucose that begins to build up in the bloodstream.

Diabetes results when the body stops producing insulin or when the pancreas begins to slow production of insulin after a period of high demand, often caused by insulin resistance.

Treatment for Insulin Resistance

If the pancreas is still making adequate amounts of insulin, but the cells are becoming increasingly desensitized to it, there are medications that can be taken to "re-sensitize" the liver and muscle cells. One class of drug is metformin (Glucophage) and the other is thiazolinediones (Actos and Avandia).

The same lifestyle changes that are recommended for those with diabetes – weight management, exercise, eating a balanced diet – are also beneficial in preventing insulin resistance from becoming a diagnosis of diabetes.

Because there is no specific diagnostic test for insulin resistance, and because there are no symptoms, a patient can have it for many years before diagnosis. Because of this, behavioral changes that would have delayed, or even prevented, the onset of diabetes are not made. The patient eventually receives a diagnosis of type 2 diabetes, a disease they will need to manage for the remainder of their lives.

Sources: About Diabetes and National Institutes of Health


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