Insulin resistance
Insulin resistance or Metabolic syndrome is a condition where the body's insulin is not properly utilized. This condition also called Syndrome X is often called impaired fasting glucose (IFG) or Pre-diabetes. In an attempt to compensate the insulin resistance, the body produces extra insulin that leads directly or indirectly to the metabolic abnormalities.
Causes for Syndrome X
Obesity metabolic syndrome: A large waistline or abdominal obesity, which generally is 40 inches or more for men and 35 inches or more for women.
Physical inactivity: Metabolic syndrome is associated with sedentary lifestyles like adipose tissue, reduced HDL cholesterol, increased triglycerides (fat found in blood), blood pressure and glucose in the genetically susceptible.
Aging: The prevalence of metabolic syndrome increases with age.
Diabetes Mellitus: Metabolic syndrome is found in large majority of patients with Type-2 diabetes or impaired glucose tolerance (IGT).
Coronary Heart Disease: Patients with coronary heart disease are at higher risk of developing metabolic syndrome.
Tackling Metabolic Resistance
Physical activity for at least 30 to 60 minutes a day is generally recommended. Losing weight is imperative to dealing with metabolic syndrome. Follow a healthy diet. Insulin resistance is increased by smoking cigarettes. part from weight loss and exercise, few drugs are also prescribed to reduce the LDL cholesterol levels. Drugs prescribed for this kind of treatment include statin, a fibrate drug or a combination of a statin with either niacin or a fibrate.
Glucose Tolerance Test
Glucose Tolerance Test or GTT is a laboratory blood test that is done to check the efficiency with which the body is able to metabolize sugar. The Glucose tolerance test is used to detect insulin resistance, diabetes and hypoglycemia. Initially the blood is tested after a fasting period of about 6 hours. Typically this fasting test is done on a person early morning after having refrained from eating or drinking anything after midnight. Then the person is given a certain amount of glucose is administered. The blood is then tested again after 30 minutes and 60 minutes.
Typical results of GTT:
Fasting for about 6 hours: 60 -100 mg/dL. If your readings show 100 - 110 mg/dL, you might be suffering impaired fasting glycaemia or pre-diabetes condition.
1 hour after glucose consumption or after a meal: less than 200 mg/dL
2 hours after glucose consumption or after a meal: less than 140 mg/dL. Between 140 - 200 mg/dL also might be indicative of pre-diabetes.
Polycystic Ovarian Syndrome
In PCOS, under-developed follicles accumulate in the ovaries. Since they fail to mature, they accumulate as cysts in the ovaries. The low levels of follicle stimulating hormone (FSH) and elevated levels of androgens may be the reasons for this condition. When there is no ovulation, the progesterone hormone is not created and the lining of the uterus is not shed in a timely fashion. This increases the chances of endometrial hyperplasia and even cancer.
Another feature associated with PCOS is hyper androgenism or increased responsiveness to testosterone. This usually shows up in oily skin and acne. Excess hair may be noticed on the face and other parts of the body. Women suffering from PCOS have a weight problem, especially around the waist. Insulin resistance is also noticed in some women. This increases the risk of developing diabetes in later years.
Polycystic Ovarian Syndrome Symptom
- Absence of menses or abnormal or scanty menstrual periods
- Weight gain
- Infertility
- Aggravated acne
- Increased hair growth in a male pattern
High levels of insulin can result in symptoms such as high androgen levels, infertility and lack of ovulation. These symptoms are usually noticed when women are in their 20s or 30s. Diagnosis of PCOS is after a physical examination and laboratory tests. Thyroid and prolactin levels in the blood are tested. Serum levels of male hormones (DHEA and testosterone) are tested for higher than normal levels. Tumors in the ovary or adrenal glands can be diagnosed with vaginal and abdominal ultrasounds. Insulin resistance is vital in the diagnosis of PCOS. Insulin is instrumental in regulating the ovarian function. An ovarian biopsy may also be done.
Treatment for Polycystic Ovarian Syndrome
Treatment for women with Polycystic Ovarian Syndrome depends on what stage of a woman's life this condition has manifested and her fertility desires. Birth control pills are prescribed to regularize the menstrual cycle and reduce the risk of uterine cancer. Other medications used in the treatment of PCOS are flutamide and spironolactone.
Clomiphene induces the pituitary gland to secrete more FSH and this stimulates release and maturity of ova. Insulin resistance is reduced with drugs such as Metformin (Glucophage) and Troglitazone. 'Ovarian drilling' is a process of using laser to place small holes in the ovaries so as to normalize the hormonal environment and allow normal ovulation.
Bibliography / Reference
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