Insulin Resistance

What Is Insulin Resistance?

Insulin resistance happens when the body doesn't respond to the hormone insulin as it should, making it hard for glucose to get into cells. Glucose comes from food and is the body's main source of energy. Normally, insulin helps glucose enter the cells.

Insulin resistance can raise a child's risk for type 2 diabetes and other health problems. To help improve the body's response to insulin, doctors recommend that kids and teens:

• Get to and maintain a healthy weight.
• Eat a balanced diet rich in whole grains, fruits and vegetables, and lean protein.
• Exercise regularly.

What Are the Signs & Symptoms of Insulin Resistance?

People with insulin resistance may have:

• high body mass index (BMI) and waist circumference
• high fasting blood sugar
• acanthosis nigricans, a darkening of the skin in folds and creases, like the neck and armpits

Other medical problems linked to insulin resistance and obesity include:

• fatty liver (extra fat in the liver)
• polycystic ovary syndrome (PCOS), when girls have heavy or irregular periods, or even no periods
• high blood pressure (hypertension)
• obstructive sleep apnea

Insulin resistance is most common in people who are overweight and have too much belly fat. Insulin resistance is also linked to some genetic syndromes, conditions that affect hormone levels and stress levels, and some medicines.

Obesity and insulin resistance tends to run in families. Other things that put someone at risk for insulin resistance include:

• not being physically active
• a high-carbohydrate diet
• smoking

How Is Insulin Resistance Diagnosed?

Doctors might think it's insulin resistance if an overweight or obese person has acanthosis nigricans, a family history of diabetes, or heart disease. They may:

• check BMI and waist measurement
• take a blood pressure reading
• do blood tests, including:
  • fasting glucose and/or hemoglobin A1c
  • fasting insulin
  • lipid profile

Insulin resistance and obesity tend to go hand-in-hand. So doctors might order more tests to look for other weight-related problems, like fatty liver, PCOS, and sleep apnea.

How Is Insulin Resistance Treated?

Insulin resistance is treated with positive lifestyle changes. Weight loss can lead to big improvements in blood sugar, lipids (cholesterol level), and blood pressure. Exercise (and regular physical activity) is especially helpful. In kids who are still growing, slowing the rate of weight gain or keeping a healthy weight also will help.

Families can work with their health care provider, a dietitian, or a weight management program to build healthy habits. These might include:

• limiting junk food and sugary beverages
• eating more fruit and vegetables
• choosing whole grains
• reducing screen time
• getting more exercise
• not smoking

What Else Should I Know?

Sometimes, insulin resistance and other problems don't get better with lifestyle changes alone. Some kids may need medicines that increase insulin sensitivity as well as treatment for other conditions, like high blood pressure. For some teens with insulin resistance and severe obesity, doctors may recommend weight loss surgery.