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November 24, 2009
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Insulin Resistance (cont.)

Who is at risk for insulin resistance?

Individuals are more likely to have or develop insulin resistance if they:

  • are overweight with a body mass index (BMI) more than 25

  • are a man with a waist more than 40 inches or a woman with a waist more than 35 inches

  • are over 40 years of age

  • are Latino, African American, Native American or Asian American

  • have close family members with type 2 diabetes, high blood pressure or arteriosclerosis

  • have had gestational diabetes

  • have high blood pressure, high blood triglycerides, low HDL cholesterol or arteriosclerosis (for example, have other components of the metabolic syndrome)

  • have polycystic ovarian disease

  • have acanthosis nigricans

How is insulin resistance diagnosed?

A physician can identify individuals who are likely to have insulin resistance with a detailed patient history, patient physical examination, and laboratory testing utilizing the risk factors. There are some very sophisticated tests for the diagnosis or confirmation of insulin resistance such as euglycemic insulin clamping or intravenous tolerance testing. However, these are expensive or complicated and are not necessary for managing patients. These tests are used primarily for research purposes.

In general clinical practice, glucose levels in conjunction with fasting insulin levels can give the physician a clue as to whether insulin resistance is present or not in patients without diabetes. A firm diagnosis can not be made simply based on this, since the lab techniques for measuring insulin can vary, and there is no absolute value that meets a definition. However, a level above the upper quartile in the fasting state in someone without diabetes is considered abnormal.



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