Insulin Resistance

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KEY POINTS

• Insulin resistance means your child’s body makes enough insulin, but the cells are not able to use it properly. Over time, if insulin resistance is not treated and gets worse, it may lead to diabetes.
• Treatment includes healthy lifestyle changes such as losing weight, eating a variety of healthy foods, quitting smoking or using e-cigarettes, and increasing physical activity to help lower blood glucose (sugar) levels.

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What is insulin resistance?

Insulin is a hormone made by the pancreas, an organ in the upper belly. Your child’s body breaks down some of the foods your child eats into glucose (sugar). Then, it uses insulin to help move glucose from the blood into the cells for energy.

Insulin resistance means your child’s body makes enough insulin, but the cells are not able to use it properly. Glucose can’t get into the cells and stays in the blood. This causes higher than normal levels of blood glucose and is not good for your child’s health. Over time, if insulin resistance is not treated and gets worse, it may lead to diabetes. It may also increase your child’s risk for heart disease.

What is the cause?

The exact cause of insulin resistance is not known. Your child may have an increased risk for insulin resistance if your child:

• Is overweight or has obesity, especially extra weight around the belly
• Does not get enough physical activity
• Has family members with insulin resistance or diabetes
• Is of African American, Alaska Native, American Indian, Hispanic/Latino, Asian American, or Pacific Islander descent
• Has had an abnormal fasting blood glucose test
• Takes certain medicines such as steroids
• Has certain medical conditions such as high blood pressure, high cholesterol, polycystic ovarian syndrome, fatty liver, or sleep apnea
• Uses nicotine in smoking, electronic cigarettes, chewing tobacco, or nicotine gum

What are the symptoms?

Most of the time, there are no symptoms. In some cases, insulin resistance may cause dark patches on the skin of the back of the neck, armpits, elbows, knuckles, or knees. This condition is called acanthosis nigricans.

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your child will have blood tests.

How is it treated?

Treatment includes lifestyle changes to help lower blood glucose levels:

• Weight loss. If your child is overweight, your healthcare provider may recommend a plan for weight loss. Even a small amount of weight loss can help.
• Increased physical activity. Increased activity and exercise improves blood flow, uses up more of the glucose in the blood, and helps your child’s body use insulin better.
• Changes to your child’s meal plan. Your healthcare provider may recommend your child eat less of certain foods such as white bread, pasta, white rice, potatoes, sugary drinks, juices, and foods that contain simple sugars. Sugary and starchy foods raise blood glucose levels and can make insulin resistance worse. Also, try to help your child eat more lean protein, fruits, vegetables, and whole grains, and drink more water.
• Sometimes your child’s healthcare provider may prescribed medicine to lower blood glucose levels

How can I take care of my child and prevent insulin resistance?

Follow the full course of treatment prescribed by your child’s healthcare provider. In addition:

• Make sure that your child stays physically active as advised by your child’s provider. Ask your healthcare provider for advice about the best kind of activity for your child.
• Help your child eat a variety of healthy foods that includes fruits, vegetables, lean protein, and high-fiber grains. Include healthy fats such as small servings of nuts, seeds, avocado, olive oil, and fish oil. Limit sugars, sugary drinks, and desserts. Avoid the white foods such as white flour products, white bread, biscuits, pancakes, white potatoes, and white rice. Help your child choose more whole grains such as whole wheat flour, bran, oatmeal, quinoa, brown rice. You may want to work with a dietitian to set up a meal plan that meets your child’s needs.
• Help your child keep a healthy weight. If your child is overweight or has obesity, your healthcare provider can help with a safe, healthy, effective weight loss program.
• Make sure that your child gets enough sleep.
• Talk to your child about the risks of smoking, using e-cigarettes, drinking alcohol, and using drugs.
• Ask your child’s provider:
  • How and when you will get your child’s test results
  • If there are activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.