How Do I Know If I Have Insulin Resistance?

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PCOS and insulin resistance are frequently found together, which makes it important to understand this common problem.

How Insulin Works

Insulin is a hormone that is produced by the pancreas, a gland in the abdomen with a lot of functions. It is typically secreted in response to a large amount of glucose, or sugar, in the blood. Once produced, insulin causes glucose to be taken into the body cells to be used for energy.

Women with PCOS frequently have insulin resistance, meaning their body does not respond as quickly to insulin. The sluggish response will cause larger and larger amounts of insulin to be required before glucose is taken into the body tissues, and eventually a change in the way the body deals with sugar. Worsening insulin resistance can eventually lead to diabetes.

Certain characteristics are common in people with insulin resistance:

  • Being overweight, especially around the midsection
  • Sedentary lifestyle
  • Age greater than 40 years
  • High blood pressure
  • High cholesterol
  • Having PCOS
  • Certain ethnic groups (Hispanic, African American or Native American)

Signs and Symptoms of Insulin Resistance

Besides blood tests, there are some common signs and symptoms of insulin resistance that women with PCOS tend to experience. These include:

  • Fatigue
  • Increased hunger
  • Strong cravings for sweets and salty foods
  • Acanthosis nigricans, latin term for dark skin, typically in the areas of the groin, armpit or behind the neck

    If you meet some of these criteria, your doctor may suspect that you are insulin resistant. The next step is blood testing to look at how well your body deals with sugar. These tests, used to diagnose pre-diabetes or diabetes, include the fasting glucose level and the glucose tolerance test.

    Fasting Glucose Level

    Before having this test, you will need to fast for approximately 8 hours.

    Then, a simple blood sample is taken and the amount of glucose in the blood is measured. According to the American Diabetes Association (ADA), if your result is:

    • Below 100mg/dl; this is a normal result.
    • 100mg/dl to 125mg/dl; it indicates impaired fasting glucose, or pre-diabetes.
    • Above 125mg/dl; a diagnosis of diabetes may be made.

    Glucose Tolerance Test

    Again, you will need to fast for at least 8 hours before this test, and while the test is being performed. Your physician will give you a sugary liquid to drink in 5 minutes (for some this is harder than it sounds). Blood tests will be drawn before the test begins, and again at two hours afterward. While not common, your doctor may also request that blood be drawn at different intervals in addition to the standard ones listed above. Normally, blood sugar should return to normal within 3 hours. If blood sugar levels are elevated beyond the test, it may indicate that you are insulin resistant.

    What You Can Do

    No matter what your results are from the testing, it is important to follow up appropriately with your physician. They may want you to repeat the test now or within a specific time frame (such as in one year). If the test does come back abnormal, you may want to see a nutritionist for dietary advice and possibly a doctor who specializes in managing diabetes.

    With the right changes to your lifestyle and medications and supplements, you can reverse insulin resistance if you have PCOS. 

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