Signs and Symptoms of Insulin Resistance
Insulin resistance (often considered one component of a larger constellation known as “metabolic syndrome”) has become well recognized as an important indicator of the potential to develop diabetes (and cardiovascular disease, among others), with some doctors referring to it as “pre-diabetes”. It occurs when the body’s cells no longer respond to insulin the way they should, and as a result, sugar remains in the bloodstream rather than enter these dysfunctional cells. This results in high blood sugar (hyperglycemia), which can lead to a number of symptoms and potential problems, now and in the future.
What are the signs and symptoms of insulin resistance?
The signs and symptoms of insulin resistance are the same or similar to those for anyone with hyperglycemia, which is directly causing such manifestations in the body. Someone experiencing this state may become excessively thirsty, with consequent increased urination, and he/she may feel sluggish, fatigued and/or dizzy. As the blood sugar level rises, one may experience additional signs and symptoms, such as blurred vision, and in extreme cases, coma or even death.
In addition, the longer this condition remains untreated, the more likely it is that the patient will experience additional problems secondary to the effects of hyperglycemia on organs such as the kidneys and heart. Some of the conditions that are highly linked to insulin resistance include hypertension (high blood pressure), type-2 diabetes, atherosclerosis (hardening of the arteries) and an excess of various fats and lipids (cholesterol, triglycerides) in the blood, among several others.
What is LADA?
LADA, or Latent Autoimmune Diabetes in Adults, is a fairly recent discovery that describes a condition that has features of both type-1 and type-2 diabetes, but is thought to be somewhat distinct from either one in terms of pathology and presentation. For this reason, it has alternatively been labeled as type-1.5 diabetes, indicating its place between the two standard forms of the disease. It is believed that approximately 10% of type-2 diabetics have actually been misdiagnosed and should be categorized as LADA sufferers instead.
The reason it is known as type-1.5 is because it has certain features of both type-1 and type-2 diabetes. Like type-1, it has been shown to be autoimmune in nature, with circulating autoantibodies that are thought to attack the insulin-producing beta cells of the pancreas. However, similar to the type-2 presentation (and unlike type-1), LADA often appears in adulthood, without an immediate need for insulin (insulin dependence). For these reasons, many doctors have settled on one of these two monikers, although it is still uncertain whether LADA is a totally distinct entity, or merely a variation of type-1 pathology that shows delayed onset (“latent”) for some reason.
What kinds of blood sugar levels would indicate that I have LADA?
There is no specific blood sugar level that can indicate this. A blood glucose level above 100 mg/dL is generally considered to be high, and would therefore place the patient in the hyperglycemic category, regardless of the cause. But in order to establish a diagnosis of LADA, the physician must order an antibody test in the face of a supporting clinical picture. If positive, this test indicates that there are antibodies directed against the pancreas that either weren’t evident previously (as in type-1), or haven’t yet expressed themselves (hence the latency).
Can I have insulin resistance without having a type of diabetes?
Yes. Insulin resistance is usually considered one aspect of the aforementioned “metabolic syndrome”, which can have a very varied presentation. Without getting into too much detail, it is possible to display a level of insulin resistance, and even be categorized as suffering from metabolic syndrome, without having a formal diagnosis of diabetes.
However, the take away message for anyone concerned with this issue is that left untreated, such resistance will almost certainly eventually yield full-blown diabetes, as well as a host of other bodily complications that range from annoying to life-threatening. So while the technical answer is yes, it is not advisable to view a lack of official diabetes diagnosis in the face of insulin resistance to be an indication that one should not be concerned with developing diabetes.
Questions for your doctor:
- If I am diagnosed with type-2 diabetes, how can I be sure that it’s not type-1.5, or LADA? How often is this diagnosis missed these days?
- Are there any additional tests, besides antibodies, that might point to LADA as the problem? If so, what are they and where can they be tested? (i.e. a special lab?)
- What are the treatment recommendations for LADA, and how are they different from those for frank diabetes?
- Do I have metabolic syndrome? What does that mean in terms of treatment and comorbidity with other conditions/illnesses?
- How do I know when to see an endocrinologist instead of my primary care physician?
- Can you tell me any places to obtain good, accurate information about these subjects?
About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians. After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time. He may be reached at firstname.lastname@example.org.
This blog post was originally published by AutoimmuneMom.com, written by Dr. Rothbard , and first published on Oct 9, 2012.
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