Questions in diabetes: what is hyperinsulinemia?

Hyperinsulinemia is an elevated level of insulin in the blood. This condition is associated with glucose intolerance, obesity, hypertension, and dyslipidemia, collectively referred to as the metabolic syndrome.

What is hyperinsulinemia?

Hyperinsulinemia is different from diabetes or hyperglycemia, but it results from prediabetes, which can progress to diabetes if not properly treated.

Hyperinsulinemia is a precursor to diabetes.

Hyperinsulinemia leads to several conditions, which are described below:

• Hypoglycemia or low blood sugar.

• Diabetes or uncontrolled blood sugar levels that fluctuate between low and high levels.

• Increased risk of developing polycystic ovary syndrome (PCOS).

• Increased production of very low density lipoproteins (VLDL) – hypertriglyceridemia.

• Increased risk of cardiovascular or heart disease.

• Coronary heart disease – high insulin levels damage the endothelial cells that line the coronary arteries.

• Hypertension or high blood pressure.

• Pathology of the thyroid gland.

• Obesity.

Causes of hyperinsulinemia

Insulin resistance is the main cause of hyperinsulinemia. When a person has insulin resistance, the pancreas tries to compensate by producing more insulin.

This can lead to type 2 diabetes, which occurs when the pancreas does not produce enough insulin to adequately regulate blood sugar levels.

Rarely, a pancreatic tumor can cause hyperinsulinemia. A condition called nonsidioblastosis , where there is an excess of insulin-producing cells in the pancreas, can also lead to hyperinsulinemia.

Symptoms of hyperinsulinemia

There is often no clear indication of hyperinsulinemia, although the following symptoms may be present :

• “Sugar” cravings.

• Intense hunger.

• Poor concentration.

• Weight gain.

• Increased frequency of hunger attacks.

• Episodes of panic or anxiety.

• Fatigue.

The earlier this condition is diagnosed, the more likely it is that the above problems can be prevented or reduced.

Features of the treatment of hyperinsulinemia

Because hyperinsulinemia is a hallmark of type 2 diabetes, treatment approaches are the same. Experts recommend cutting calories, as well as cholesterol, salt, and alcohol.

Other recommended lifestyle changes include reducing stress and increasing exercise. At least 30 to 60 minutes of moderate to vigorous exercise three times a week is recommended to help people lose weight.

Dietary changes

Even within a few days of starting a calorie-restricted diet, insulin sensitivity may improve. A diet of whole, fresh, high-fiber, low-glycemic foods is recommended. Examples include vegetables, fruits, whole grains, and beans.

Dietary changes in hyperinsulinemia are the main care for patients.

Carbohydrate intake should be moderately low, around 45-65% of total daily caloric intake. Saturated fats should be avoided, and healthy monounsaturated fats and omega-3 fats should make up 25%-35% of daily calories.

Sources of monounsaturated fats are nuts, avocados, and olive oil, while walnuts and fish are good options for omega-3 fats.

Saturated fat should be limited to less than 7% of daily calories and trans fatty acids to less than 1%.

Protein should make up 12%-20% of your daily calorie intake.

Drugs for hyperinsulinemia

In cases where hyperinsulinemia does not respond to lifestyle changes, medications may be prescribed to maintain normal blood sugar levels.

Remember that only a doctor prescribes treatment – the groups of drugs are given for informational purposes only.

Insulin secretion inhibitors

An example of an insulin secretagogue is diazoxide, a thiazide drug that opens a potassium adenosine triphosphate (ATP) channel in the beta cell membrane. It forms the release of insulin from the pancreas, and also stimulates the release of glucose from the liver and the release of catecholamines, which increases blood sugar levels.

Glucose release stimulators

Dextrose or D-glucose is given intravenously to quickly raise blood sugar levels. Glucagon is another substance that can be given intravenously or intramuscularly to raise blood sugar levels. Glucagon stimulates the release of glucose from the liver through gluconeogenesis.

Drugs that suppress the action of insulin

In cases where patients do not respond to this treatment, hydrocortisol and cortisol are used to try to suppress the action of insulin. Although this therapy does not help all patients.