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Are you thin but have a roll of fat around your middle? Do you wake up every morning promising to give up sweets but lose the battle around midday? Do you feel constantly tired, despite a good night’s sleep? If the answer is yes, chances are that you are one of the millions who suffers from insulin resistance but just doesn’t know it.

Insulin resistance is fairly common and often hard to  diagnose. In this condition, the cells become resistant to insulin and as a result the body keeps  pumping out more, which, in turn, makes the cells even more resistant, ending up in a vicious cycle. Insulin resistance causes a whole set of health concerns that if not managed well can wreak havoc. Here are some consequences of the illness.

Afternoon slump

Condition: When you feel constantly tired, rely on snacks or coffee to keep you going, have a general feeling of lethargy and suffer from mental fog around midday, then you most likely go through what is called the afternoon slump.

Insulin connection: Also referred to as syndrome X, this is a pre-diabetic state in which the body tops using sugar properly. “The afternoon slump can either be a sign of stress, lack of sleep or a warning symptom for a serious metabolic disorder where the person suddenly undergoes lack of focus and fatigue,” says Dr Atul Aundhekar, Chief Medical Director, iCare Clinics. “Pre-diabetic individuals usually overproduce insulin in order to maintain blood sugar levels. This fluctuation in sugar levels can result in periods of extreme fatigue and exhaustion,” he adds.

Management: The most important aspect of living with insulin resistance or even reversing it is adopting healthy eating habits rather than assuming extreme weight-loss solutions will be the  answer. Besides controlling portions, protein is a vital nutrient, so stick to consuming plenty of lean meat, fish and eggs. Avoid foods that have a high glycaemic index as this can result in a spike in sugar levels. So refrain from consuming fruit juices, caffeine, soda, soft drinks, alcohol, wheat, corn, rice and potatoes, which are rich in sugar and starch.

Polycystic ovary syndrome (PCOS)

Condition: Research shows that one in every five women in the UAE may have PCOS. Normally found in women of childbearing age, PCOS affects the menstrual cycle, ability to have children, hormone levels and even the heart. Typically women who have this condition have high levels of the male hormone androgen, are overweight, and have irregular or missed periods and cysts in their ovaries.

Insulin connection: The prominent feature of PCOS is high insulin levels in blood. This leads to high androgen levels, resulting in acne and excessive body hair, explains Dr Fatin Khidhir, Specialist Obstetrician and Gynaecologist, Mediclinic Welcare Hospital. “PCOS is one of the most common endocrine disorders and associated with obesity. Between 40 and 60 per cent of women with PCOS are overweight or obese due to insulin resistance,” adds Dr Khidhir.

Management: While a slow and frustrating process, there are four areas of management, says Dr Khidhir. These include lowering of insulin resistance levels, restoration of fertility, treatment of excessive hair and acne, and restoration of regular menstruation.

Hashimoto’s thyroiditis

Condition: Hashimoto’s thyroiditis is an autoimmune disorder of the thyroid that ultimately leads to hypothyroidism, which can cause insulin resistance. Insulin connection: Insulin resistance indicates reduced sensitivity of the target tissues to the metabolic effects of insulin. In the initial phase the pancreas compensates for the resistance by more insulin secretion. Though obesity is the usual cause, insulin resistance could be caused by genetic hereditary factors, hormonal disorders and drugs. Among the hormonal causes both hypothyroidism and hyperthyroidism could lead to insulin resistance,” says Dr Ajith Kumar, Specialist Endocrinologist, Aster Medical Centre.

Management: Hashimoto’s thyroiditis is an organ-specific autoimmune disease, with no  consequences except hypothyroidism, in most cases, points out Dr Kumar. “It should not be treated with immunosuppressant drugs, as such treatments are ineffective to prevent or reverse  hypothyroidism and these drugs cause serious adverse events.”

Weight gain

Condition: All people with insulin resistance do not have to be overweight, but majority will display a distinct fattening or thickening of the midsection of the body (cross-section pictured), and when not checked this can lead to obesity.

Insulin connection: “It is now recognised that patients with insulin resistance produce more  inflammatory chemicals that, in turn, affect the thyroid gland, causing it to slow down secretions, which affects the overall metabolism, leading to weight gain,” says Dr Abdul Jabbar, Professor of Medicine and Consultant Endocrinologist, Medcare Hospital.

Management: Adopting a healthy lifestyle with a balanced diet and a good exercise regime can help control insulin resistance. It is recommended to adopt an eating plan that comprises wholefoods that are high in fibre, colourful fruits and vegetables and low in sugar and white flour. This helps stabilise blood sugar levels, reduce inflammation and oxidative stress and improve liver detoxification, says Dr Jabbar.