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  • Writer's pictureMichael McEntee

What to know about insulin resistance

Insulin, a hormone that the pancreas makes, allows cells to absorb and use glucose. In people with insulin resistance, the cells are unable to use insulin effectively. When the cells cannot absorb glucose, levels of this sugar build up in the blood. If glucose, or blood sugar, levels are higher than usual but not high enough to indicate diabetes, doctors refer to this as prediabetes. Prediabetes often occurs in people with high insulin resistance.

What is insulin resistance?

Insulin resistance occurs when excess glucose in the blood reduces the ability of the cells to absorb and use blood sugar for energy. This increases the risk of developing pre-diabetes, and eventually, type 2 diabetes. If the pancreas can make enough insulin to overcome the low rate of absorption, diabetes is less likely to develop, and blood glucose will stay within a healthy range.

How does insulin resistance become diabetes?

In a person with pre-diabetes, the pancreas works increasingly hard to release enough insulin to overcome the body’s resistance and keep blood sugar levels down. Over time, the pancreas’ ability to release insulin begins to decrease, which leads to the development of type 2 diabetes. Insulin resistance remains a major feature of type 2 diabetes.


Insulin is essential for regulating the amount of glucose that circulates in the bloodstream. It induces the cells to absorb glucose. Insulin is also the chemical messenger that instructs the liver to store some glucose, rather than releasing it into the bloodstream. The liver packages glucose for storage in the form of glycogen. Insulin usually helps the body maintain a good balance of energy, never allowing the level of blood glucose to spike for too long. The reasons for insulin resistance remain complex, and researchers continue to investigate.

The following steps outline the medical community’s current understanding of insulin resistance:

1. The body’s cells become less affected by insulin.

2. This resistance initially causes the pancreas to secrete more insulin, in order to maintain safe blood sugar levels.

3. The pancreas becomes unable to maintain the release of extra insulin to compensate for the cells’ increasing resistance.

4. Consistently high levels of blood glucose develop, progressing into pre-diabetes and type 2 diabetes if a person does not adopt management strategies and receive treatment.

Risk factors

The following are risk factors for insulin resistance, pre-diabetes, and diabetes:

  • being overweight or having obesity, especially when the extra weight is around the midriff

  • a sedentary lifestyle or one that is low in exercise

  • smoking

  • sleep issues

  • high blood pressure, which one 2018 study has linked to an increased risk of insulin resistance

Extracts taken from Adam Felman from

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