Prediabetes And Insulin Resistance: Are They The Same Thing?

It is easy to get confused when it comes to insulin resistance and prediabetes. Both of these conditions involve blood sugars getting out of balance.[1] But what differentiates one from the other? Are they different or are they the same thing?

In this article, we will cover each of these conditions so you can understand what they are, how they work, and how you can reduce your risk to keep your body healthy in the long run.

What Is Insulin?

To understand insulin resistance, we first need to understand what insulin is and how it works. Insulin is a hormone that is produced by the pancreas. Its job is to get glucose (sugar) out of your blood and into your cells where it is needed for energy. The pancreas releases insulin after you eat, when your body has broken down carbohydrates from your food into glucose and that glucose has entered your bloodstream. Insulin lowers your blood sugar levels after a meal to get them back to normal.[1-3]

Insulin Resistance

Unfortunately, our cells don't always respond to insulin properly and they can become insulin resistant. When they aren't responding to insulin well, those cells aren't able to take up glucose from the blood. As a result, the glucose stays in your blood and your blood sugar levels become very high. This is called insulin resistance.[1-3]

Insulin resistance often happens when there is a lot of glucose in your blood over a long period of time. To keep up with the high demand, your pancreas has to pump out a ton of insulin to process all that sugar. But over time, your cells stop responding to all the insulin and they become insulin resistant. The pancreas tries to make even more insulin to keep up, but it eventually fails.[1-3]

The end result from insulin resistance is an increase in blood sugar levels. The problem is that high blood glucose is very damaging to your body and can cause serious health concerns (like type 2 diabetes) if left untreated.[1-3]

What Is Prediabetes?

Prediabetes, also known as borderline diabetes, is a condition that occurs when your blood glucose levels are higher than they should be but aren't yet high enough to be considered a type 2 diabetes diagnosis.[1,4]

Prediabetes occurs when you either aren't able to make enough insulin (your pancreas isn't producing enough) or your insulin isn't functioning properly (as is the case with insulin resistance, as described above). Both of those problems will lead to higher than normal levels of glucose in the blood.[1,4] Insulin resistance is considered the main factor that drives the development of prediabetes.[5]

Prediabetes is a warning sign that things are headed into dangerous territory. If your blood sugars remain high and continue to rise, you are very likely to develop type 2 diabetes and more serious health concerns as time goes on.

Signs Of Insulin Resistance And Prediabetes

There aren't any noticeable symptoms of either insulin resistance or prediabetes, so you can have either of these conditions for years without even knowing it.[1,2]

There are other signs of trouble in the body that can often appear alongside insulin resistance, however. Some things that might alert you to the possibility of underlying insulin resistance include extra weight around your waistline, high blood pressure, and high cholesterol levels.[6]

Some people with severe insulin resistance and prediabetes can also have dark patches on their skin, which usually occur on the back of the neck or in the elbows, knees, and armpits. This is called acanthosis nigricans.[2,4]

You'll likely only develop noticeable symptoms if your insulin resistance and prediabetes gets worse and the problem progresses to type 2 diabetes. Then, you might notice things like increased thirst, frequent urination, pain or numbness in the hands and feet, or blurred vision.[6,7]

If you are concerned and are wondering whether or not you have insulin resistance or prediabetes, your best bet is to speak with your doctor to discuss all of your symptoms and health information. If your provider suspects you may have prediabetes, they will likely order blood tests to see if your blood sugar levels are too high (like a fasting plasma glucose test and an A1C test).[4]

What Causes Insulin Resistance And Prediabetes?

Researchers are still learning everything they can to better understand what causes these conditions, but they currently believe that two of the biggest factors involve being overweight and being physically inactive.[1,4,8] Other issues that may cause insulin resistance or prediabetes include eating a high-carb, high-sugar diet and dealing with chronic stress.[6]

If you are overweight or have obesity, if you are not physically active, and if you have a family history of diabetes, then you are more likely to develop insulin resistance or prediabetes.[1]

What To Do About Insulin Resistance And Prediabetes

If you have been diagnosed with either insulin resistance or prediabetes, or if you have reason to suspect that you are at high risk for these conditions, there is good news.

Both insulin resistance and prediabetes can be reversed. This means that you can not only prevent future health complications due to unregulated blood sugars down the line, but you can also reverse the problem and get back to better health.[1]

As we learned earlier, excess weight and lack of physical activity are two of the biggest contributors to prediabetes and insulin resistance. If you want to get healthy, making lifestyle changes to address both of these factors is key; losing weight and getting more regular physical activity are two of the best things you can do to support yourself. Reducing stress and getting enough sleep are also important.[3,4]

Eating a healthy diet full of nutritious foods, avoiding high-sugar foods and refined carbohydrates, and beginning a gentle exercise routine are all great places to start. 

If making these changes to your lifestyle and diet sounds a little daunting, not to worry. Lark is here to support you every step of the way. Lark's diabetes prevention program offers personalized coaching and step-by-step guidance for making healthy changes to your life that will help you to control your blood sugars and lower your risk for diabetes. Don't wait, get started today!

References

1. National Institute of Diabetes and Digestive and Kidney Diseases. Insulin Resistance & Prediabetes. National Institutes of Health. Published May 2018. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance.
2. Yale Diabetes Center. Insulin Resistance. Yale School of Medicine. https://medicine.yale.edu/intmed/endocrin/programs/diabetes/.
3. Insulin Resistance and Diabetes. Centers for Disease Control and Prevention. Reviewed August 12 2019. https://www.cdc.gov/diabetes/basics/insulin-resistance.html.
4. MedlinePlus. Prediabetes. U.S. National Library of Medicine. Reviewed May 10 2016. https://medlineplus.gov/prediabetes.html.
5. Cai X, Xia L, Pan Y, et al. Differential role of insulin resistance and β-cell function in the development of prediabetes and diabetes in middle-aged and elderly Chinese population. Diabetol Metab Syndr. 2019;11:24.
6. Insulin Resistance. Diabetes.go.uk. Updated January 15 2019. https://www.diabetes.co.uk/insulin-resistance.html.
7. Diabetes Symptoms. Centers for Disease Control and Prevention. Reviewed March 24 2020. https://www.cdc.gov/diabetes/basics/symptoms.html.
8. Miao Z, Alvarez M, Ko A, et al. The causal effect of obesity on prediabetes and insulin resistance reveals the important role of adipose tissue in insulin resistance. PLoS Genet. 2020 Sep 14;16(9):e1009018.