Insuliinivaste

Insuliinivaste, or insulin resistance, is a metabolic state in which cells in the liver, muscle, and adipose tissue respond poorly to insulin. Because of reduced insulin signaling, the pancreas may produce higher levels of insulin (hyperinsulinemia) in an attempt to keep blood glucose in check. Over time, insulin resistance can lead to elevated fasting glucose and, if persistent, type 2 diabetes.

Causes and risk factors include excess body fat, particularly around the abdomen, physical inactivity, and genetic predisposition. Conditions such as polycystic ovary syndrome (PCOS), metabolic syndrome, and non-alcoholic fatty liver disease are associated with insulin resistance. Age and certain medications can also contribute.

Diagnosis is typically based on clinical assessment and tests such as fasting glucose and insulin to calculate indices like HOMA-IR, or an oral glucose tolerance test. The euglycemic-hyperinsulinemic clamp is the research standard but is rarely used in routine care.

Management focuses on lifestyle changes: gradual weight loss, regular aerobic and resistance exercise, and a balanced diet that emphasizes fiber, lean proteins, and reduced refined carbohydrates and saturated fats. Medications such as metformin can improve hepatic insulin sensitivity and are commonly used in prediabetes and PCOS; other drugs used in diabetes management may also reduce insulin resistance. In some cases, bariatric surgery may substantially improve insulin sensitivity in individuals with obesity.

Outlook varies; early intervention can prevent progression to type 2 diabetes and reduce cardiovascular risk. Ongoing monitoring of glucose metabolism and associated conditions is recommended.