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Insulin resistance and diabetes type 2

Understanding how type 2 diabetes mellitus develops and perpetuates itself can help patients manage their condition with more insight.

Overview of insulin resistance
Development of type 2 diabetes mellitus is based on an abnormal process in the body called insulin resistance which begins many years prior to the development of high blood sugars. The endocrinologists at Houston Thyroid and Endocrine believe it is important to understand that this root problem of insulin resistance begins, on average, 5-10 years prior to the diagnosis of diabetes mellitus type 2.  Elevation of blood sugars is a symptom of this abnormal processing.

The body's insulin resistance began to rise over several years due to several processes. Aging and a family history of diabetes are processes that are out of a patient's control and predispose to the development of high blood glucose. The other processes that are within the control of a patient are lack of physical activity, poor diet leading to weight gain, and use of certain medications that contain steroids. As the insulin resistance rises, the body's pancreas has to produce more insulin to compensate, but there is a limit to this production. Once this limit is reached, blood sugars begin to rise. High insulin levels also contribute to visceral obesity which propagate this cycle. 

diabetes mellitus



Pre-diabetes

As insulin resistance is a gradual development which causes a compensatory rise in insulin production. The body can produce extra insulin for many years, but at a critical point a limit is reached.  Measuring absolute  insulin levels are not that helpful since this is a process that is relative to an individual's insulin resistance. Once there is relatively not enough insulin to overcome the resistance in the body, blood sugars begin to rise.  The diagnosis of pre-diabetes (also called impaired fasting blood glucose or impaired glucose tolerance) usually indicates that insulin resistance has been present for many years already. The cornerstone of management is a structured weight loss program. There are some medical treatment options which can be discussed with your physician. 

pre diabetes, impaired glucose tolerance insulin resistance

Diabetes Mellitus type 2

The ability of the pancreas to produce insulin at higher levels than normal is finite. At some point, the pancreas beta cells begin to fail and there is a gradual reduction in the ability to make insulin. Unless there has been aggressive intervention early in pre-diabetes, there will likely be a progressive increase of insulin resistance.  Because of the severe mismatch between insulin resistance and insulin production, blood sugars will be frankly high and the short-term complications and long-term complications of diabetes mellitus begin.  

diabetes mellitus type 2


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