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.
Next: How is insulin resistance managed? »
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