“Overweight and obesity rates have increased significantly among Peruvians due to the lack of physical activity and hypercaloric diets, rich in refined carbohydrates, saturated fats and low in fiber. This has led to health complications caused by excess weight and insulin resistance,” says Dr. Karim Kundert, an endocrinologist at our institution, who provides us with valuable information on insulin resistance.

What is insulin resistance?

Insulin resistance is a condition in which muscle, fat and liver cells do not respond adequately to this hormone and cannot properly use glucose from the blood.  As a result, the pancreas makes more insulin to help glucose enter the cells and maintain normal blood levels. Over time, the pancreas cannot keep up with this elevated production, leading to prediabetes and, in some cases, type 2 diabetes mellitus.

What are the symptoms?

Usually, this condition does not produce symptoms, but in some people excess pigmentation can be observed at the level of the neck, armpits and skin folds. This is called acanthosis nigricans.

How do I know if I have insulin resistance?

One of the main ways of detecting insulin resistance is by finding elevated levels of this hormone in a blood test, although this is not conclusive, since finding normal levels does not rule it out. In addition, evidence of abdominal obesity (waist circumference ≥ 90 cm in males and ≥ 80 cm in females) and elevated triglyceride levels are sought. These signs are indicators of insulin resistance.

What complications may this cause?

Insulin resistance can trigger various health problems such as prediabetes, type 2 diabetes mellitus, fatty liver, polycystic ovary syndrome, gestational diabetes, arterial hypertension, cholesterol and triglyceride alterations. It also produces a higher risk of cardiac and cerebral infarction, birth of babies with high birth weight and higher risk of some types of cancer, among others. Preventing these ailments is in our hands.

How to prevent insulin resistance?

• Adopt a healthy lifestyle, practicing cardiovascular or aerobic exercises on a regular basis, at least 30 minutes 5 times a week and with 2 or 3 weekly sessions of strength exercises, as long as there are no contraindications.
• Maintain an adequate weight and have a balanced diet, free of refined carbohydrates, rich in fiber and with the appropriate amount of calories for each case.
• Consume whole grains, whole cereals and legumes as a source of carbohydrates, which should not exceed a quarter of the plate. They should be accompanied by a similar portion of a protein-rich food such as lean meat cooked without fat. The other half of the plate should consist of predominantly raw vegetables, preferably including leafy greens. Fruit should be consumed in moderation, avoiding juices and extracts.

Dr. Karim Kundert
Endocrinologist at Clínica Ricardo Palma