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	James L. Holly, M.D.

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About SETMA - Special Services - Insulin Resistance

Special Services

Every adult who comes to SETMA is assessed for their risk of the development of insulin resistance and/or for its presence. Those who are at significant cardiovascular risk, and with conditions which warrant, are testing for Insulin Resistance:

With fasting blood tests of their glucose (sugar) and insulin levels. The Homeostasis Model Assessment formula (HOMA) is recognized as an effective means of quantifying insulin resistance. SETMA's electronic medical records enables SETMA providers to use this formula to assess if you have insulin resistance or not. This function is typically used in the Metabolism Clinic.
The Triglyceride/HDL ratio is calculated on all adults who have their lipids measured at SETMA. If this ratio is above 2, it is highly suggestive of the presence of insulin resistance and steps should be taken to correct this condition.

Why is it important to know if you are insulin resistant?

The underlying cause of the cluster of risk factors associated with the Metabolic Syndrome is resistance to insulin -- a hormone produced by the pancreas that helps regulate the amount of sugar in your body. Normally, your digestive system breaks down some of the food you eat into sugar (glucose). Then your body uses insulin to transport the glucose into your cells, where it is converted to energy to fuel body processes. During digestion, the sugar (glucose) in the food you eat is absorbed into your bloodstream. Insulin from your pancreas escorts glucose into your cells, where it provides energy for your body.

If your body becomes resistant to the action of insulin, glucose processing is impaired. Your body reacts by churning out more and more insulin in an effort to help glucose enter your cells. This extra insulin helps maintain normal glucose levels in your blood for a while, but eventually your pancreas is unable to overcome insulin resistance. As a result, glucose accumulates in your body, ultimately leading to type 2 diabetes. Type 2 diabetes is the most common form of diabetes. It formerly was called noninsulin-dependent diabetes or adult-onset diabetes.

What causes insulin resistance?

Those with a family history of type 2 diabetes have a genetic predisposition for the development of insulin resistance, but we think the most common cause is fat around the abdomen. Fat is a normal part of the body. It is used as insulation in the subcutaneous tissue of the skin. It is used for quick energy. But, fat is not intended to accumulate around the waist. This only happens when we overeat and/or when we are not active enough. Eating the wrong kinds of food can also contribute to abdominal obesity but generally only in the face of eating too much food. The abdominal or waist fat is always abnormal and is always harmful in any amount.

Abdominal fat cells produce many substances, all but one of which are harmful to your body. One of the abnormal substances produced by abdominal fat is Resistin, which produces insulin resistance. Resistin has increased activity in patients with obesity and/or diabetes. Resistin is a very powerful inflammatory agent which contributes to cardiovascular disease.

SETMA's Metabolism Clinic is very interested in helping you avoid, treat and/or cure insulin resistance. Join the team; get healthy.

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