What Are Insulin Resistance, Metabolic Syndrome, and Pre-Diabetes?

Learn about the conditions that greatly increase your risk for type 2 diabetes

Many people who develop type 2 diabetes are first diagnosed with one of its precursors:

• Insulin Resistance
• Metabolic Syndrome (Syndrome X)
• Pre-Diabetes

Let’s go over each of them so you can understand how they affect the body and how they develop into full-blown diabetes.

Insulin Resistance

If you have insulin resistance, your body produces insulin but does not use it properly.

Insulin is a hormone made by the pancreas that helps the body burn glucose for energy. Glucose is a simple sugar and a major source of fuel for cells. Most of the food we consume is converted into glucose.

In the bloodstream, insulin helps glucose and other nutrients enter cells. However, if there is not enough insulin in the bloodstream to “unlock” the cells so that nutrients can get in, the cells literally starve to death.

When you are insulin resistant, your body requires extra insulin in order for this “unlocking” process to work. The pancreas will try to keep up with this increased need by producing more insulin, but eventually it will fail to produce the amount your body needs. When this occurs, the extra glucose will begin building up in your blood, and type 2 diabetes will develop.

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Metabolic Syndrome (Syndrome X)

In addition to being the driving force behind type 2 diabetes, insulin resistance is also part and parcel of a condition known as metabolic syndrome (formerly called syndrome X). Metabolic syndrome is a cluster of disorders that includes:

• Obesity (especially abdominal obesity: a waist measurement of 40 inches or more for men and 35 inches or more for women)
• High blood pressure (130/85 or higher)
• Elevated triglycerides (150 mg/dL or higher)
• Low HDL cholesterol (below 40 mg/dL for men and below 50 mg/dL for women)
• Increased risk of heart disease and type 2 diabetes

The underlying constant among all of these characteristics is insulin resistance. Other risk factors associated with metabolic syndrome include:

• Age (the older you are, the higher your risk)
• Sedentary lifestyle
• Hormone imbalances
• Poor diet (particularly a diet high in saturated and trans fats and sugar)

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Pre-Diabetes

Pre-diabetes is diagnosed when a person’s blood sugar is elevated, but not quite to diabetic levels.

People with pre-diabetes have either impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or both. To test for IFG, you must fast overnight and then have your blood sugar levels tested in a physician’s office. If your fasting blood sugar level is 100–125 mg/dL, you have IFG. To test for IGT, you will need to undergo a two-hour oral glucose tolerance test. If your blood sugar level is 140–199 mg/dL, then you have IGT.

A diagnosis of pre-diabetes doesn’t necessarily mean you will develop type 2 diabetes. Studies have shown that people with pre-diabetes who lose weight and increase their level of physical activity can prevent or delay type 2 diabetes and get their blood sugar levels back to normal.

While it makes sense to find out if you have pre-diabetes so you can take steps to prevent it from turning into full-blown type 2 diabetes, I only recommend taking these tests if you know you are at high risk for developing the disease.

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More Dr. Whitaker Advice on Blood Sugar and Diabetes

• What causes diabetes?
• What are the symptoms of diabetes?
• How to prevent type 2 diabetes