Insulin Resistance: Dealing With the Diagnosis

When my daughter was a pre-teen, her routine blood glucose test came back a little high. Her pediatrician had her undergo a special test called a fasting blood glucose test, which was followed by a series of other tests. The results prompted her doctor to come back with a chilling diagnosis: insulin resistance.

As a pediatric nurse, I was familiar with the topic of diabetes and insulin resistance, but this was a frightening diagnosis. My daughter was very upset, thinking she now had a terrible disease. And both my husband and daughter turned to me for ways to deal with this new diagnosis.

What is insulin resistance?

It's a condition in which the hormone, insulin, becomes less effective at managing sugar levels in the blood glucose after eating or drinking anything that contains a simple sugar.

Insulin is produced by the pancreas and acts to open the doors of the cells, taking glucose out of the bloodstream and putting it into the cells for energy. When cells don't respond enough to insulin, blood glucose levels rise as a result.

How serious is insulin resistance?

The presence of insulin resistance typically precedes the diagnosis of type 2 diabetes, previously known as adult onset diabetes. When an individual has diabetes, his or her pancreas does not make enough insulin to keep blood sugars level. This is a chronic disease which can result in a number of side effects and disabilities.

How do I know if my child has insulin resistance?

The signs and symptoms can vary with each person, but some are very noticeable. In my nursing career, I have taken care of children who seem to have a dark ring around their necks that looks like oily dirt. This is not dirt and can't be washed away. It also can occur under the arms or in the groin area. This ring is called acanthosis nigricans and is a sign of insulin resistance.

Other signs of insulin resistance include:

• Brain fogginess or inability to focus,
• Depression,
• Fatigue,
• High blood sugar,
• Higher blood pressure,
• Increased hunger,
• Intestinal bloating,
• Sleepiness, especially after meals.

If your child is exhibiting these symptoms, make an appointment with their pediatrician and be sure to let his or her doctor know exactly what signs your child has been displaying.

At Children's Hospital Los Angeles, the Division of Endocrinology and Metabolism provides clinical care and research focused on childhood diabetes, growth, weight management, endocrinology and bone metabolism. For more information, visit their webpage.

Diet and Exercise to Avoid Diabetes

As we researched more on the subject of insulin resistance, what became clear to my family was that this condition was something we could treat and correct, and if we did so early enough, it didn’t have to mean “diabetes” for my child.  There are some medications available, but what else could we do?  The answer was, two things:

1. Exercise
2. Healthy eating

Everything we read indicated that insulin resistance and diabetes have a relation to nutrition.  I knew that from nursing school and also had some tools to work with because I have a long on-and-off relationship with Weight Watchers!

The Family Plan

So, as a family, we came up with a plan to make meaningful changes in our lifestyle, but none so drastic or difficult to maintain that we couldn't stick to them.

1. My daughter remembers some of the basics:
2. No more fast food,
3. No excessively sugary drinks (including juice),
4. Lots of fruits and vegetables,
5. Reading food labels,
6. My Food Pyramid Website (Website is interactive for adults and children)

And, sadly, we also had to stop Dad from making his wonderful buttery and cheesy sauces, except as a rare treat!

Balance and variety were important. So what to choose?

• Fresh, colorful vegetables and fruits,
• Whole grains,
• Healthy fats, not trans fats,
• Avoid heavily processed foods, high fructose corn syrup and excessively-sugared beverages.

Many weight-loss programs are low in carbohydrates (carbs), but some are needed in the diet so as not to starve the cells of energy, which can otherwise upset the body’s blood sugar balance. The carbs that do this well come from whole grains, fruits and vegetables. It's best to avoid refined sugars (or carbohydrates) and grains.

My daughter's doctor prescribed Vitamin D for her, as this is often deficient in those with insulin resistance. However, your child's doctor may or may not prescribe something different, depending on your child's needs.

What Works at Our House

To be a better role model for my daughter, I went back to Weight Watchers and my daughter came with me for a few months.  We joined a gym and made a promise to the dog to walk her more often. We stopped going to fast food places, except as a rare treat.  And we gave up sodas.

Thankfully, I had given my daughter broccoli as a baby, so she already had one vegetable she liked.  From there, we explored and tasted to integrate more vegetables and fruits into our diet. We steamed them or ate them raw to avoid adding any additional oil when possible. I tried out “lighter” recipes from books and magazines to introduce variety and make these changes into a lifestyle and not a diet.

My daughter discovered that she loved to eat couscous, a whole grain, with vegetables. There are healthier choices for snacks in every grocery store these days, but we read the labels to find the best ones.

Insulin Resistance Success Story

My daughter's blood sugar levels are now normal and she no longer has insulin resistance. Knowing that once you are insulin resistant, you continue to be at risk for insulin resistance and hyperglycemia, however, it can be controlled with diet and exercise. Because she made some simple life changes and stuck with them, she was able to successfully lower her risk of developing diabetes later in life.