insulin resistance: basic overview

If you have PCOS, you have probably read about insulin resistance (or IR). Maybe your doctor has talked to you about it. Or maybe you keep seeing books out there with titles like The Insulin Resistance Diet or Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance.

Most women with PCOS have a basic idea of what IR is. It means that your body is not as good as it should be at using insulin to control glucose levels, so you have to make more insulin than you should really need; eventually, it’s too much for your pancreas to handle and your blood glucose levels begin to rise. This is why, even though you may hear IR described as “too much insulin” and think it is the opposite of diabetes, it is really related to diabetes, and can often lead to diabetes if left unchecked. Your pancreas can’t continue to make huge amounts of insulin forever.

There are some other reasons that producing lots of insulin is undesirable. It affects the balance of other hormones in the body: for example, it spurs your body to produce more testosterone, which contributes to the symptoms of PCOS (hirsutism, acne, thinning of hair on the head). Testosterone also disturbs the menstrual cycle. It can suppress ovulation and lead to infertility or other problems of the reproductive system, such as menstrual irregularity.

Too much testosterone and insulin also set up conditions that cause weight gain and make it very hard to lose weight. In particular, insulin resistant people often carry weight around the midsection, which is the most dangerous place to have it. This fat, which is called “visceral fat,” is more hazardous to your health than fat carried in other places. (It’s not clear to me why this is; however, scientists and researchers are finding that the old view of the fat cell as something that just sits there is quite wrong, and that fat cells produce hormones.)

I will post more on this topic, including details on how to test for insulin resistance and what kind of steps you can take to fight against it; however, the important thing to remember is that if you have PCOS, you are probably at least mildly insulin resistant, and the treatments for it are mostly things that will be good for you anyway (like a healthful diet and exercise).