What is insulin resistance? Doctor says there is a chance for it to change into diabetes so how does that happen?

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I have been diagnosed with PCOS and insulin resistance. I am curious about what it is and why does it makes me at a high risk for diabetes.

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Insulin is the hormone that tells your body to absorb glucose from the blood into cells so that you can use it to make energy.

When you have insulin resistance, your cells ignore the insulin and glucose builds up in your blood. As long as your pancreas can make enough insulin to overcome the resistance, your blood glucose remains normal.

Diabetes happens when the level of glucose in your blood (consistently) reaches a certain point. Type 2 means you make insulin, but it doesn’t do its job (because there’s not enough of it), type 1 means your pancreas can’t make insulin.

Insulin resistance means your bodies cells are not responding to insulin like they should. Your body still makes insulin, but it isn’t used as effectively. The amount your body makes does not lower the blood sugar as much as it should in a normal person.

Once you become resistant to insulin enough, it is classed as type 2 diabetes. Diet and exercise can help keep your sugar in check and slow/prevent progression to diabetes.

When we eat, as part of the digestion process, food gets broken down and its component parts get taken up into our blood. One of those parts is glucose. Normally insulin is the hormone in our bodies that takes glucose from our blood and sends into cells where it can be stored and used.

People with Type 1 diabetes don’t produce any insulin. So they need to inject insulin when they eat to help package up the glucose.

People with type 2 diabetes produce insulin, but it just doesn’t work anymore. For some reason it can no longer properly package glucose into cells. Insulin resistance is essentially the early stages of type 2 diabetes – the insulin is working, but it’s not working as well as it should. If it gets worse it becomes type 2 diabetes. We’re not 100% sure about the exact mechanism that causes this yet, but we do know that the most effective ways to prevent it are exercise, and good diet. There’s also a few types of drugs that can be taken (Metformin is the main one). Generally the recommendation is that people start them as soon as possible, because we know that the better control someone has over their blood sugar in the early stages, the better their blood sugar control control and health are in the later stages.

Having too much glucose in your blood, like what happens in diabetes, is bad. Firstly because glucose irritates the lining of blood vessels, and down the track this leads to long term damage and problems with poor blood supply in peripheral tissues like toes and feet. This is why people get something called peripheral neuropathy, which is where they basically lose all sensation in their extremities. Because of this people often hurt themselves and get pressure sores without realising, and then because of the poor blood flow they just never really heal. Worst case scenario (but sadly far too common) is amputation. Secondly, if you can’t package glucose into your cells, your cells have nothing to use for energy and they’re essentially starving. One of the things your body does in response is mobilise it’s fat stores. So you’ve then got heaps of fat hanging out in your blood all the time. This, plus the inflammation from having all the glucose in your blood, means that you get heaps of fatty plaques being created in the walls of your blood vessels. These fatty deposits are what cause heart attacks and strokes.