Exit

Health Condition

Insulin Resistance Syndrome

About This Condition

The insulin resistance syndrome (IRS; also called metabolic syndrome) is a group of health risk factors that increase the likelihood of heart disease,1,2,3,4 and perhaps other disorders, such as diabetes and some cancers.5,6 The risk factors that make up IRS include insulin resistance, which refers to the reduced ability of the hormone insulin to control the processing of glucose by the body. Other major risk factors often associated with IRS include high blood sugar and high blood triglycerides, low HDL (“good”) cholesterol, high blood pressure, and excessive body fat in the abdominal region. People with IRS do not always have every one of these risk factors, but they usually have many of them. A qualified doctor should make the diagnosis of IRS after a thorough examination and blood tests.

Most people with type 2 diabetes have insulin resistance, but many more people who are not diabetic also have insulin resistance.7,8,9 Since insulin resistance itself often does not cause symptoms, these people may not be aware of their problem. Some authorities believe insulin resistance is partially inherited and partially due to lifestyle factors.

In addition to the recommendations discussed below, people with IRS may benefit from some of the recommendations given for type 2 diabetes. People with IRS should also benefit from health strategies that reduce the severity of the risk factors they possess, including obesity, high triglycerides, and high blood pressure.

Symptoms

People with IRS may be overweight (especially in the trunk area), feel sluggish after eating, and may have been told that they have high blood pressure and high cholesterol.

Other Therapies

Treatment typically includes dietary changes to limit fat and calories, increased exercise, and changes in habits or patterns of eating.

References

1. Lempiainen P, Mykkanen L, Pyorala K, et al. Insulin resistance syndrome predicts coronary heart disease events in elderly nondiabetic men. Circulation 1999;100:123-8.

2. Vanhala MJ, Pitkajarvi TK, Kumpusalo EA, Takala JK. Obesity type and clustering of insulin resistance-associated cardiovascular risk factors in middle-aged men and women. Int J Obes Relat Metab Disord 1998;22:369-74.

3. Yip J, Facchini FS, Reaven GM. Resistance to insulin-mediated glucose disposal as a predictor of cardiovascular disease. J Clin Endocrinol Metab 1998;83:2773-6.

4. Pyorala M, Miettinen H, Halonen P, et al. Insulin resistance syndrome predicts the risk of coronary heart disease and stroke in healthy middle-aged men: the 22-year follow-up results of the Helsinki Policemen Study. Arterioscler Thromb Vasc Biol 2000;20:538-44.

5. Moore MA, Park CB, Tsuda H. Implications of the hyperinsulinaemia-diabetes-cancer link for preventive efforts. Eur J Cancer Prev 1998;7:89-107 [review].

6. Stoll BA. Western nutrition and the insulin resistance syndrome: a link to breast cancer. Eur J Clin Nutr 1999;53:83-7 [review].

7. Liese AD, Mayer-Davis EJ, Haffner SM. Development of the insulin resistance syndrome: an epidemiologic perspective. Epidemiol Rev 1998;20:157-72.

8. Trevisan M, Liu J, Bahsas FB, Menotti A. Syndrome X and mortality: a population-based study. Am J Epidemiol 1998;148:958-66.

9. Valdez R. Epidemiology. Nutr Rev 2000;58:S4-S6 [review].

10. Vuksan V, Sievenpiper JL, Owen R, et al. Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. Diabetes Care 2000;23:9-14.

11. Landin K, Holm G, Tengborn L, Smith U. Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men. Am J Clin Nutr 1992;56:1061-5.

12. Cavallo-Perin P, Bruno A, Nuccio P, et al. Dietary guar gum supplementation does not modify insulin resistance in gross obesity. Acta Diabetol Lat 1985;22:139-142.

13. Mertz W. Chromium in human nutrition: a review. J Nutr 1993;123:626-33 [review].

14. Anderson RA. Chromium, glucose intolerance and diabetes. J Am Coll Nutr 1998;17:548-55 [review].

15. Vincent JB. Mechanisms of chromium action: low-molecular-weight chromium-binding substance. J Am Coll Nutr 1999;18:6-12 [review].

16. Anderson RA. Nutritional factors influencing the glucose/insulin system: chromium. J Am Coll Nutr 1997;16:404-10 [review].

17. Morris BW, MacNeil S, Stanley K, et al. The inter-relationship between insulin and chromium in hyperinsulinaemic euglycaemic clamps in healthy volunteers. J Endocrinol 1993;139:339-45.

18. Vuksan V, Sievenpiper JL, Owen R, et al. Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. Diabetes Care 2000;23:9-14.

19. Landin K, Holm G, Tengborn L, Smith U. Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men. Am J Clin Nutr 1992;56:1061-5.

20. Cavallo-Perin P, Bruno A, Nuccio P, et al. Dietary guar gum supplementation does not modify insulin resistance in gross obesity. Acta Diabetol Lat 1985;22:139-142.

21. Sanchez M, de la Sierra A, Coca A, Oral calcium supplementation reduces intraplatelet free calcium concentration and insulin resistance in essential hypertensive patients. Hypertension 1997;29:531-6.

22. Singh RB, Niaz MA, Rastogi SS, et al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens 1999;13:203-8.

23. Nadler JL, Buchanan T, Natarajan R, et al. Magnesium deficiency produces insulin resistance and increased thromboxane synthesis. Hypertension 1993;21:1024-9.

24. Humphries S, Kushner H, Falkner B. Low dietary magnesium is associated with insulin resistance in a sample of young, nondiabetic Black Americans. Am J Hypertens 1999;12:747-56.

25. Rosolova H, Mayer O Jr, Reaven G. Effect of variations in plasma magnesium concentration on resistance to insulin-mediated glucose disposal in nondiabetic subjects. J Clin Endocrinol Metab 1997;82:3783-5.

26. Paolisso G, Di Maro G, Galzerano D, et al. Pharmacological doses of vitamin E and insulin action in elderly subjects. Am J Clin Nutr 1994;59:1291-6.

27. Barbagallo M, Dominguez LJ, Tagliamonte MR, et al. Effects of vitamin E and glutathione on glucose metabolism: role of magnesium. Hypertension 1999;34:1002-6.

28. Singh RB, Niaz MA, Rastogi SS, et al. Current zinc intake and risk of diabetes and coronary artery disease and factors associated with insulin resistance in rural and urban populations of North India. J Am Coll Nutr 1998;17:564-70.

29. Chen MD, Lin PY, Lin WH. Investigation of the relationships between zinc and obesity. Kao Hsiung I Hsueh Ko Hsueh Tsa Chih 1991;7:628-34 [in Chinese].

30. Baba NH, Sawaya S, Torbay N, et al. High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects. Int J Obes Relat Metab Disord 1999;23:1202-6.

31. Wolfe BM. Potential role of raising dietary protein intake for reducing risk of atherosclerosis. Can J Cardiol 1995;11:127G-131G.

32. Wolfe BM, Piche LA. Replacement of carbohydrate by protein in a conventional-fat diet reduces cholesterol and triglyceride concentrations in healthy normolipidemic subjects. Clin Invest Med 1999;22:140-8.

33. Purnell JQ, Brunzell JD. The central role of dietary fat, not carbohydrate, in the insulin resistance syndrome. Curr Opin Lipidol 1997;8:17-22 [review].

34. Marshall JA, Bessesen DH, Hamman RF. High saturated fat and low starch and fibre are associated with hyperinsulinaemia in a non-diabetic population: the San Luis Valley Diabetes Study. Diabetologia 1997;40:430-8.

35. Feskens EJ, Loeber JG, Kromhout D. Diet and physical activity as determinants of hyperinsulinemia: the Zutphen Elderly Study. Am J Epidemiol 1994 15;140:350-60.

36. Daly ME, Vale C, Walker M, et al. Dietary carbohydrates and insulin sensitivity: a review of the evidence and clinical implications. Am J Clin Nutr 1997;66:1072-85 [review].

37. Daly ME, Vale C, Walker M, et al. Acute effects on insulin sensitivity and diurnal metabolic profiles of a high-sucrose compared with a high-starch diet. Am J Clin Nutr 1998;67:1186-96.

38. Wolever TM. Dietary carbohydrates and insulin action in humans. Br J Nutr 2000;83:S97-S102 [review].

39. Mathers JC, Daly ME. Dietary carbohydrates and insulin sensitivity. Curr Opin Clin Nutr Metab Care 1998;1:553-7 [review].

40. Frost G, Leeds A, Trew G, et al. Insulin sensitivity in women at risk of coronary heart disease and the effect of a low glycemic diet. Metabolism 1998;47:1245-51.

41. Kiens B, Richter EA. Types of carbohydrate in an ordinary diet affect insulin action and muscle substrates in humans. Am J Clin Nutr 1996;63:47-53.

42. Jenkins DJ, Axelsen M, Kendall CW, et al. Dietary fibre, lente carbohydrates and the insulin-resistant diseases. Br J Nutr 2000;83:S157-S163 [review].

43. Barnard RJ, Wen SJ. Exercise and diet in the prevention and control of the metabolic syndrome. Sports Med 1994;18:218-28 [review].

44. Storlien LH, Kriketos AD, Calvert GD, et al. Fatty acids, triglycerides and syndromes of insulin resistance. Prostaglandins Leukot Essent Fatty Acids 1997;57:379-85 [review].

45. Riccardi G, Rivellese AA. Dietary treatment of the metabolic syndrome—the optimal diet. Br J Nutr 2000;83:S143-S148 [review].

46. Torjesen PA, Birkeland KI, Anderssen SA, et al. Lifestyle changes may reverse development of the insulin resistance syndrome. The Oslo Diet and Exercise Study: a randomized trial. Diabetes Care 1997;20:26-31.

47. Anderssen SA, Hjermann I, Urdal P, et al. Improved carbohydrate metabolism after physical training and dietary intervention in individuals with the “atherothrombogenic syndrome.” Oslo Diet and Exercise Study (ODES). A randomized trial. J Intern Med 1996;240:203-9.

48. Reaven GM. Do high carbohydrate diets prevent the development or attenuate the manifestations (or both) of syndrome X? A viewpoint strongly against. Curr Opin Lipidol 1997;8:23-7 [review].

49. Connor WE, Connor SL. Should a low-fat, high-carbohydrate diet be recommended for everyone? The case for a low-fat, high-carbohydrate diet. N Engl J Med 1997;337:562-3 [editorial].

50. Williams DE, Prevost AT, Whichelow MJ, et al. A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome. Br J Nutr 2000;83:257-66.

51. Belfiore F, Iannello S. Insulin resistance in obesity: metabolic mechanisms and measurement methods. Mol Genet Metab 1998;65:121-8.

52. Frayn KN. Visceral fat and insulin resistance—causative or correlative? Br J Nutr 2000;83:S71-7 [review].

53. Haffner SM. Obesity and the metabolic syndrome: the San Antonio Heart Study. Br J Nutr 2000;83:S67-70.

54. Okosun IS, Liao Y, Rotimi CN, et al. Abdominal adiposity and clustering of multiple metabolic syndrome in white, black and hispanic americans. Ann Epidemiol 2000;10:263-70.

55. Ross R, Dagnone D, Jones PJ, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 2000;133:92-103.

56. Bessesen DH. Obesity as a factor. Nutr Rev 2000;58:S12-S15 [review].

57. Torjesen PA, Birkeland KI, Anderssen SA, et al. Lifestyle changes may reverse development of the insulin resistance syndrome. The Oslo Diet and Exercise Study: a randomized trial. Diabetes Care 1997;20:26-31.

58. Grundy SM. Hypertriglyceridemia, insulin resistance, and the metabolic syndrome. Am J Cardiol 1999;83:25F-29F [review].

59. Tahtinen TM, Vanhala MJ, Oikarinen JA, Keinanen-Kiukaanniemi SM. Effect of smoking on the prevalence of insulin resistance-associated cardiovascular risk factors among Finnish men in military service. J Cardiovasc Risk 1998;5:319-23.

60. Mikhailidis DP, Papadakis JA, Ganotakis ES. Smoking, diabetes and hyperlipidaemia. J R Soc Health 1998;118:91-3 [review].

61. Henkin L, Zaccaro D, Haffner S, et al. Cigarette smoking, environmental tobacco smoke exposure and insulin sensitivity: the Insulin Resistance Atherosclerosis Study. Ann Epidemiol 1999;9:290-6.

62. Eliasson B, Taskinen MR, Smith U. Long-term use of nicotine gum is associated with hyperinsulinemia and insulin resistance. Circulation 1996;94:878-81.

63. Assali AR, Beigel Y, Schreibman R, et al. Weight gain and insulin resistance during nicotine replacement therapy. Clin Cardiol 1999;22:357-60.

64. Eliasson B, Attvall S, Taskinen MR, Smith U. Smoking cessation improves insulin sensitivity in healthy middle-aged men. Eur J Clin Invest 1997;27:450-6.

65. Alcohol and Public Health: What does moderate drinking mean? Centers for Disease Control and Prevention [last updated 2014 Mar 14, cited 2014 Jun 9]. Available from URL: www.cdc.gov/alcohol/faqs.htm#moderateDrinking.

66. Flanagan DE, Moore VM, Godsland IF, et al. Alcohol consumption and insulin resistance in young adults. Eur J Clin Invest 2000;30:297-301.

67. Kiechl S, Willeit J, Poewe W, et al. Insulin sensitivity and regular alcohol consumption: large, prospective, cross sectional population study Bruneck study. BMJ 1996;313:1040-4.

68. Mayer EJ, Newman B, Quesenberry CP Jr, et al. Alcohol consumption and insulin concentrations. Role of insulin in associations of alcohol intake with high-density lipoprotein cholesterol and triglycerides. Circulation 1993;88:2190-7.

69. Lazarus R, Sparrow D, Weiss ST. Alcohol intake and insulin levels. The Normative Aging Study. Am J Epidemiol 1997;145:909-16.

70. Rimm EB, Klatsky A, Grobbee D, Stampfer MJ. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits? BMJ 1996;312:731-6 [review].

71. Hendriks HF, Veenstra J, Velthuis-te Wierik EJ, et al. Effect of moderate dose of alcohol with evening meal on fibrinolytic factors. BMJ 1994;304:1003-6.

72. van Baak MA, Borghouts LB. Relationships with physical activity. Nutr Rev 2000;58:S16-S18 [review].

73. Borghouts LB, Keizer HA. Exercise and insulin sensitivity: a review. Int J Sports Med 2000;21:1-12 [review].

74. Eriksson J, Tuominen J, Valle T, et al. Aerobic endurance exercise or circuit-type resistance training for individuals with impaired glucose tolerance? Horm Metab Res 1998;30:37-41.

75. Smutok MA, Reece C, Kokkinos PF, et al. Effects of exercise training modality on glucose tolerance in men with abnormal glucose regulation. Int J Sports Med 1994;15:283-9.

76. How much physical activity do adults need? Centers for Disease Control and Prevention [last updated 2014 Mar 3, cited 2014 Jul 9]. Available from URL: http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html.

77. Eriksson J, Taimela S, Koivisto VA. Exercise and the metabolic syndrome. Diabetologia 1997;40:125-35 [review].

78. McLaughlin T, Abbasi F, Carantoni M, et al. Differences in insulin resistance do not predict weight loss in response to hypocaloric diets in healthy obese women. J Clin Endocrinol Metab 1999;84:578-81.

79. Brandi LS, Santoro D, Natali A, et al. Insulin resistance of stress: sites and mechanisms. Clin Sci (Colch) 1993;85:525-35.

80. Keltikangas-Jarvinen L, Ravaja N, Raikkonen K, et al. Relationships between the pituitary-adrenal hormones, insulin, and glucose in middle-aged men: moderating influence of psychosocial stress. Metabolism 1998;47:1440-9.

81. Raikkonen K, Keltikangas-Jarvinen L, Adlercreutz H, Hautanen A. Psychosocial stress and the insulin resistance syndrome. Metabolism 1996;45:1533-8.

Copyright © 2018 Healthnotes, Inc. All rights reserved. www.healthnotes.com

Learn more about Healthnotes, the company.

The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

Drugs used to treat INSULIN RESISTANCE SYNDROME. Select drug name to view medication information and pricing