Am I Insulin Resistant?

In my last post, I discussed Metformin and how it lowers insulin levels.  So how do you know if you are insulin resistant and have high insulin levels?  There are signs, symptoms, and laboratory results that can tell you.

The symptom that I see the most is pronounced carbohydrate cravings.  Because of hormonal changes that occur naturally as we approach the peri-menopause and menopause years, there is a natural pre-disposition to insulin resistance.  This is true of men in the same age range also.  The typical scenario I see is a middle aged patient who has difficulty losing weight and craves carbs like never before.  All of their weight gain seems to be in their mid section.

The sign that I see the most is called acanthosis nigricans.  It is a darkening of the skin in the crease on that back of the neck, and/or in the armpits and groin.  It is quite common to also see the development of skin tags in association with this.  In younger women who are still in their menstruating years, the development of acanthosis nigricans, skin tags, abnormal facial hair growth, and abnormal menses indicates that they have PCOS.  This is a syndrome that causes insulin resistance.

Another sign that is almost universally present with insulin resistance is the deposition of new abdominal fat.  Patients will tell me that this is where they gain their weight first.  This finding indicates an absolute health disaster waiting to happen.  If this is taking place in you, you should immediately initiate a low carbohydrate diet, and consider adding phentermine and metformin to assist you in your efforts to lose abdominal fat.

There are some lab tests that can assist in the diagnosis of insulin resistance.  At the office, I order these sometimes.  Often, all I need to diagnose insulin resistance is the signs and symptoms.  If I need to get labs, there are four tests that can be ordered: Hemoglobin A1c, Fasting Blood Sugar, Oral Glucose Tolerance Test, and NMR Lipoprofile.  All of our providers are skilled in determining whether or not patients need any of these tests, and we can make the appropriate recommendations to you.

In sum:  if you are a middle age person and you are experiencing increased carb cravings, weight gain in your midsection, and possibly acanthonsis nigricans, then we should discuss insulin resistance at your next visit.  You will need to begin restricting carb intake.  Labs may need to be ordered and the addition of Metformin to your medication regimen could be very helpful.  

Wickham