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IRS & Obesity

 Overweight? Find out if Insulin Resistance Syndrome (IRS) is the cause, and how to treat it.

Researchers at the Centers for Disease Control and Prevention (CDC) estimate that as many as one in three Americans may suffer from Insulin Resistance Syndrome. This syndrome also known as Metabolic Syndrome or Syndrome X, is a newly identified cluster of diseases that is associated with obesity.

What is Insulin Resistance Syndrome (IRS)?

The ability of the hormone insulin to cause the glucose in the blood stream to be taken up by body tissues varies greatly from person to person. In insulin resistance, tissue receptors respond poorly to stimuli of the insulin hormone. In response, the pancreas secretes more insulin, to make-up for this resistance. Therefore, individuals with insulin resistance have high plasma insulin levels.

The syndrome is made up of a group of medical conditions that may include obesity, hypertension, dyslipidemia, type 2 diabetes, and hyperinsulinemia.  Although the disease process can remain effectively hidden for years, some clues of this syndrome may be seen as abdominal obesity, fatigue, poor mental concentration, fluid retention, nerve damage and an intense craving for sweets. 

What does it mean to have Insulin Resistance Syndrome?

Insulin Resistance Syndrome can be thought of as a group of silent vascular diseases.  Insulin resistance puts individuals at significant increased risk for heart attack or stroke.  Although overt type 2 diabetes may develop in some patients with the Insulin Resistance Syndrome, the majority however, will not develop diabetes but will still develop heart disease. Many individuals may also have high cholesterol, high triglycerides and high blood pressure.  Women with polycystic ovary syndrome, are at higher risk for heart disease and type 2 diabetes.  Individuals who are overweight are especially at risk of developing insulin resistance and its associated medical conditions.  Most of the associated medical conditions with Insulin Resistance Syndrome are silent until they have caused significant damage to the body, at which time they may manifest as a heart attack or a stroke.

How can I know if I have Insulin Resistance Syndrome?

A comprehensive history and physical examination by a qualified physician, as well as a proper laboratory evaluation will help diagnose the silent conditions associated with the Insulin Resistance Syndrome.  Since such conditions as high blood pressure or high cholesterol are easily detectable, treatable, and if diagnosed early, their long-term sequela preventable, it is advised that everyone be checked regularly.

Insulin Resistance Syndrome and Central Obesity

Central adiposity, also referred to as the apple shaped body or beer belly, is due to intra-abdominal fat deposition, which is closely associated with heart disease, diabetes and other medical conditions related to the Insulin Resistance Syndrome. There is a strong correlation between abdominal fat deposition and the degree of insulin resistance, independent of total body weight.  A waist-hip ratio of greater than 1.0 in men or 0.8 in women corresponds to being at high risk for Insulin Resistance Syndrome and for heart disease. 

How can I treat Insulin Resistance Syndrome?

Weight loss is essential to reversing insulin resistance and its associated conditions.  An individualized lifestyle modification is required for all patients with the Insulin Resistance Syndrome.  Lifestyle factors that need to be evaluated and addressed include alcohol, smoking, stress, lack of exercise, and excess fat or simple sugars in the diet.  Medications that help reduce insulin resistance and help decrease excess weight may be indicated.  Liposuction may also be beneficial in reducing insulin resistance.

Insulin Resistance Syndrome
may present with some of the following conditions:

•    Hyperinsulinemia
•    Glucose intolerance
•    Overweight:
•    Hypertension,
•    Type 2 diabetes mellitus
•    Gestational diabetes
•    Elevated triglycerides
•    Low HDL
•    Elevated cholesterol
•    Heart disease
•    Acanthosis nigricans
•    Polycystic ovary syndrome (PCOS)

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