Why insulin resistance can lead to weight gain, diabetes

Insulin is one of about 50 hormones circulating in the body, each playing a vital role in regulating the biological systems that keep you healthy.

Your body relies on insulin, produced by the pancreas, to keep blood sugar under control. When the hormone goes out of whack, you can gain weight, become prediabetic and, ultimately, may develop type 2 diabetes if the sequence continues.

"The amount of insulin your body produces has the potential to create the chronic condition of diabetes, which can affect your organs, circulation and vision if it's not well managed," explains Janet Durham, a Sentara family medicine nurse practitioner. "The good news is that we can take steps in many cases to delay or prevent type 2 diabetes from occurring if we can identify the problem early."

Type 1 and type 2 diabetes are similar diseases, but the cause is different. Type 1 diabetes is considered an autoimmune disorder because the immune system destroys cells in the pancreas that make insulin. Type 2 diabetes is largely caused by lifestyle factors - having a high BMI, not exercising regularly and eating a diet with a lot of processed foods and carbs.

Insulin and blood sugar

After you eat, your glucose or blood sugar levels rise. The extent that it increases depends on what you eat. Food with a high glycemic index (GI) raises blood sugar quickly. This includes processed foods, sweets, white rice and bread, chips and some fruits, such as watermelon. Lower glycemic foods include proteins, beans, certain fruits, green vegetables and carrots.

When glucose levels rise, the pancreas releases insulin, which moves glucose out of the blood and into muscle, fat and liver cells, where it's stored to use as energy. As long as that process works normally, blood glucose levels remain steady.

What is insulin resistance?

Insulin resistance occurs when cells in your muscles, fat and liver stop responding well to insulin, and sugar builds up in the blood. To compensate for increased blood glucose levels, your pancreas makes more insulin to sweep glucose into your cells.

"For some people, the body reaches a tipping point, and it can't produce enough insulin to cope with the amount of blood sugar," Durham explains. "So instead of glucose going into the liver or muscle cells, the body begins to store the excess sugar as fat, which is how weight gain occurs."

According to the National Institute of Diabetes and Digestive and Kidney Diseases, insulin resistance risk factors include:

• Weight - Being overweight or obese, especially having excess body fat in the belly and around the organs
• Age - 45 or older
• Genetics - Having a parent or sibling with diabetes
• Ethnicity - African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian or Pacific Islander American
• Physical inactivity
• Health conditions High blood pressure and abnormal cholesterol levels, heart disease
• History of gestational diabetes

Prediabetes and diabetes

About one out of every three adults is prediabetic, but most don't know it, according to the National Institutes of Health. For someone who is prediabetic, blood glucose levels are higher than normal but not high enough to be diagnosed as diabetic. They usually have no symptoms, so the condition is identified through blood tests.

"If your provider doesn't order these blood tests at your yearly checkup, be proactive and ask for them," Durham says. "The goal is to diagnose this early so we can help you make health and lifestyle changes to prevent diabetes from developing."

Sentara offers a Diabetes Prevention Program at some locations.