Insulin Resistance & Cardiovascular Disease

Written by: Lexie Villariasa
Medically reviewed by: Robert Philibert MD PhD
 
What is insulin resistance?
Insulin is a crucial hormone that acts as a regulator of cellular metabolism. Insulin resistance is an impaired biologic response to insulin. During the earlier stages of resistance, an serum insulin concentration initially increases in attempts to lower serum glucose levels. However, this compensatory mechanism is not completely effective and results in defective insulin signaling in muscle, adipose, and liver cells, affecting the transport of glucose into cells. As a result, glucose cannot be used efficiently by our body for energy. Insulin resistance usually occurs with the clinical onset of type 2 diabetes and affects control of type 1 diabetes.
 
What are the risk factors associated with insulin resistance?
Risk for insulin resistance can begin at an early age. For example, obesity associated with abnormal lipid profiles at a younger age has been heavily linked to insulin resistance. There are multiple other risk factors including:

  • Increased blood pressure
  • Low HDL cholesterol levels
  • High triglyceride levels
  • Increased fibrinogen levels
  • >Increased blood viscosity
  • Increased uric acid
  • Premature atherosclerosis
  • Endothelial dysfunction

 
How does insulin resistance relate to heart disease?
Insulin resistance has been associated with increased risk for cardiovascular events. According to an estimation done by the Archimedes model, insulin resistance is the most important single predictor of coronary artery disease. In individuals with insulin resistance, there are increased levels of fibrinogen and other clotting factors. This increases risk for clotting, impairing the body’s ability to dissolve clots. The compensatory hyperinsulinemia that comes with insulin resistance can also play a role in forming atherosclerotic plaques. Hyperglycemia associated with insulin resistance is associated with alterations in cardiac metabolic functions, leading to diabetes, oxidative stress, hypertension, and endothelial dysfunction. All of these factors work synergistically to increase the likelihood of heart disease.
 
How do I reverse insulin resistance?
It is important to recognize the signs and symptoms that come with insulin resistance. Understanding what causes the symptoms and the steps that can be taken to reverse or prevent resistance is key to combating insulin resistance. A sedentary lifestyle can lead to insulin sensitivity, while an active lifestyle can improve insulin sensitivity. Staying physically active for at least 30-45 minutes a day a few times a week can also help with maintaining a healthy weight. Obesity contributes to insulin sensitivity, so it is also important to incorporate balanced healthy meals into a diet. Diets high in carbohydrates and sugars should be avoided to decrease the risk of insulin resistance. Monitoring blood glucose levels and going for routine check-ups at your healthcare provider are also steps that can be taken to prevent insulin resistance.
 
References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC380256/
  2. https://cardiab.biomedcentral.com/articles/10.1186/s12933-018-0762-4
  3. https://pubmed.ncbi.nlm.nih.gov/31336505/
  4. https://care.diabetesjournals.org/content/27/4/1011
  5. https://academic.oup.com/jcem/article/86/2/713/2841063
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