'Curbing insulin resistance can help prevent or delay diabetes'

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Checking on your insulin resistance levels may be key in preventing or delaying the onset of diabetes, top diabetologists said on Sunday.

India has a staggering 101 million individuals afflicted by diabetes, while the number of prediabetes stands at 136 million, according to 2023 data from the Indian Council of Medical Research (ICMR). With no immediate and effective changes brought, the numbers are expected to double in the coming two decades.

"Curbing insulin resistance can certainly help to prevent or delay diabetes. This can be achieved by lifestyle modification including calorie restriction, reduction in carbohydrates, improving physical activity, proper sleep, etc.," Dr V Mohan, chairman of Dr Mohan's Diabetes Specialities Centre.

What is insulin resistance?
The term ‘insulin resistance' means that the action of insulin is impaired primarily in disposing of the glucose or lowering the glucose level. It can occur at various sites, including the liver, muscle, and adipose tissue. Most obese people do have insulin resistance, but unless there is decreased pancreatic beta cell function, that is, decreased insulin secretion, insulin resistance does not always lead to diabetes, said Dr Mohan.

"Insulin resistance is a phenomenon in which there is resistance to the action of circulating insulin at the cellular level, in particular, in the liver, in the muscle, and in fact," Dr Ambrish Mithal, chairman, Endocrinology and Diabetes, Max HealthCare, said.

What are the symptoms?
Dr Mithal noted that there are hardly any symptoms of insulin resistance. But when severe, pigmentation is a classic sign.

"Somewhat velvety pigmentation, which begins with just pigmentation, later thickens and turns velvety at the nape of the neck, the neck creases, the axilla that is the armpit, and even near the elbow." This is typically combined with obesity (especially abdominal obesity). Skin tags are also a sign of insulin resistance, Dr Mohan said.

He noted that insulin resistance may set in at any age, but it usually starts with puberty, and in girls, it is associated with Polycystic Ovarian Disease (PCOD).

"In girls, it is associated with hirsutism (excess facial hair, irregular periods, etc.) but it may also occur in males," Dr Mohan told IANS.

How to curb insulin resistance?
In addition to diabetes, insulin resistance is also associated with several other conditions, including obesity, and cardiovascular diseases like heart attacks.

Dr Mohan advised lifestyle modification including calorie restriction, reduction in carbohydrates, improving physical activity, proper sleep, etc. "Avoid refined carbohydrates, take carbohydrates with a lot of fibre, avoid fats, particularly the saturated fats like butter and ghee, eat nuts like almonds, walnuts -- healthy sources of fats," Dr Mithal said.

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