OverviewWhat is insulin resistance? A Mayo Clinic expert explainsLearn about insulin resistance from Eleanna De Filippis, M.D., Ph.D., an endocrinologist at Mayo Clinic. Show
Hello. I'm Dr. Eleanna De Filippis, an endocrinologist at Mayo Clinic. In this video, we'll cover the basics of insulin resistance. What is it? Who gets it? The symptoms, diagnosis and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. To understand insulin resistance, often referred to as prediabetes, let's first talk about what insulin does. When you eat food, your body converts that food into dietary sugars. Insulin is a hormone released by the pancreas that tells your cells to open up to that sugar and convert it into energy. With insulin resistance, the cells don't react, and don't open up, resulting in excessive sugar in the blood. Over time, the pancreas keeps trying to regulate the blood sugar, producing more and more insulin until it wears out and can't produce large amounts of insulin anymore. As a result, blood sugar levels increase to the point of being in the diabetic range. Who gets it? Anyone can become insulin-resistant. In particular, people with excess weight are at a higher risk, compared to the general population. Risk is further increased with a family history of type two diabetes, age over 45, African, Latino or Native American ancestry, smoking, and certain medications, including steroids, anti-psychotics, and HIV medication. There are other medical conditions associated with insulin resistance, like obstructive sleep apnea, fatty liver disease, polycystic ovarian syndrome, also known as PCOS, Cushing's syndrome, and lipodystrophy syndromes. Lipodystrophy syndromes are conditions that cause abnormal fat loss. So carrying either too much or not enough fat tissue in your body can be associated with insulin resistance. What are the symptoms? Very often people with insulin resistance don't have any symptoms at all. It is usually picked up by their doctor during an annual health exam or routine blood work. There are some signs of insulin resistance that your doctor may look for. These includes a waistline over 40 inches in men, and a waistline over 35 inches in women. Skin tags or patches of dark velvety skin called acanthosis nigricans. A blood pressure reading of 130 over 80 or higher. A fasting glucose level equal or above 100 milligrams per deciliter. Or a blood sugar level equal or above 140 milligrams per deciliter two hours after a glucose load test. An A1C between 5.7% and 6.3%. A fasting triglycerides level over 150 milligram per deciliter. And an HDL cholesterol level under 40 milligrams per deciliter in men, and an HDL cholesterol level under 50 milligrams per deciliter in women. How is it diagnosed? If your doctor spots these symptoms, they may follow up with a physical exam and a variety of blood tests that measure the levels of glucose, or sugar, in your blood and/or your tolerance to that glucose. Or more recently, a blood test called hemoglobin glycosylated A1C, often simply referred to as A1C. How is it treated? Reversing insulin resistance and preventing type two diabetes is possible through lifestyle changes, medication, or sometimes both. Healthy bodies come in different shapes and sizes. Losing weight through drastic means can be dangerous and counterproductive. Instead, get ideas from a doctor or a nutritionist about ways to incorporate healthy foods like fruits, vegetables, nuts, beans, and lean proteins into your meals. Also, consider incorporating exercise and movement into your day-to-day life in ways that make you feel good. What now? Even though permanently defeating insulin resistance isn't always possible, you can help your body to be more receptive to insulin. Listen to your body, reduce stress, give it the nutrition and activity it desires. If you'd like to learn even more about insulin resistance, watch our other related videos or visit mayoclinic.org. We wish you well. Prediabetes means you have a higher than normal blood sugar level. It's not high enough to be considered type 2 diabetes yet. But without lifestyle changes, adults and children with prediabetes are at high risk to develop type 2 diabetes. If you have prediabetes, the long-term damage of diabetes — especially to your heart, blood vessels and kidneys — may already be starting. There's good news, however. Progression from prediabetes to type 2 diabetes isn't inevitable. Eating healthy foods, making physical activity part of your daily routine and staying at a healthy weight can help bring your blood sugar level back to normal. The same lifestyle changes that can help prevent type 2 diabetes in adults might also help bring children's blood sugar levels back to normal. SymptomsPrediabetes doesn't usually have any signs or symptoms. One possible sign of prediabetes is darkened skin on certain parts of the body. Affected areas can include the neck, armpits and groin. Classic signs and symptoms that suggest you've moved from prediabetes to type 2 diabetes include:
When to see a doctorSee your health care provider if you're concerned about diabetes or if you notice any type 2 diabetes signs or symptoms. Ask your health care provider about blood sugar screening if you have any risk factors for diabetes. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing
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forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. CausesThe exact cause of prediabetes is unknown. But family history and genetics appear to play an important role. What is clear is that people with prediabetes don't process sugar (glucose) properly anymore. Most of the glucose in your body comes from the food you eat. When food is digested, sugar enters your bloodstream. Insulin allows sugar to enter your cells — and lowers the amount of sugar in your blood. Insulin is produced by a gland located behind the stomach called the pancreas. Your pancreas sends insulin to your blood when you eat. When your blood sugar level starts to drop, the pancreas slows down the secretion of insulin into the blood. When you have prediabetes, this process doesn't work as well. As a result, instead of fueling your cells, sugar builds up in your bloodstream. This can happen because:
Risk factorsThe same factors that increase the odds of getting type 2 diabetes also increase the risk of prediabetes. These factors include:
Other conditions associated with an increased risk of prediabetes include:
Metabolic syndromeWhen certain conditions occur with obesity, they are associated with insulin resistance, and can increase your risk for diabetes ⸺ and heart disease and stroke. A combination of three or more of these conditions is often called metabolic syndrome:
ComplicationsPrediabetes has been linked with long-term damage, including to your heart, blood vessels and kidneys, even if you haven't progressed to type 2 diabetes. Prediabetes is also linked to unrecognized (silent) heart attacks. Prediabetes can progress to type 2 diabetes, which can lead to:
PreventionHealthy lifestyle choices can help you prevent prediabetes and its progression to type 2 diabetes — even if diabetes runs in your family. These include:
How long does it take prediabetes to go away?Reversing prediabetes
Most people diagnosed with prediabetes develop Type 2 diabetes within 10 years. This means you should have time to prevent this from happening. On the other hand, it takes about three years to reverse prediabetes.
How do I know if my prediabetes turns into diabetes?Fasting blood sugar test
Less than 100 mg/dL (5.6 mmol/L ) is normal. 100 to 125 mg/dL (5.6 to 6.9 mmol/L ) is diagnosed as prediabetes. 126 mg/dL (7.0 mmol/L ) or higher on two separate tests is diagnosed as diabetes.
Can you be prediabetic for years?You can have prediabetes for years without symptoms. This means you likely won't know you have prediabetes until serious health problems show up. Talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, including: Being overweight.
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How long does it take for prediabetes to turn into diabetes
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