Hyperinsulinemia

Insulin binding to its receptor.

Hyperinsulinemia
Classification and external resources
ICD-9	251.6

Hyperinsulinemia, or hyperinsulinaemia is a condition which there are excess levels of insulin circulating in the blood than expected relative to the level of glucose. While it is often mistaken for diabetes or hyperglycaemia, hyperinsulinemia can result from a variety of metabolic diseases and conditions. While hyperinsulinemia is often seen in people with type two diabetes mellitus, it is not the cause of the condition and is only one symptom of the disease. Hyperinsulinemia can be seen in a variety of conditions including diabetes mellitus type 2, in neonates and in drug induced hyperinsulinemia

In type two diabetes, the cells of the body become resistant to the effects of insulin as the receptors which bind to the hormone become less sensitive to insulin concentrations resulting in hyperinsulinemia and disturbances in insulin release. With a reduced response to insulin, the beta cells of the pancreas secrete increasing amounts of insulin in response to the continued high blood glucose levels resulting in hyperinsulinemia. In insulin resistant tissues, a threshold concentration of insulin is reached causing the cells to uptake glucose and therefore decreases blood glucose levels. Studies have shown that the high levels of insulin resulting from insulin resistance might enhance insulin resistance .

Hyperinsulinemia in neonates can be the result of a variety of environmental and genetic factors. If the mother of the infant is a diabetic, and does not properly control her blood glucose levels, the hyperglycemic maternal blood can create a hyperglycemic environment in the fetus. To compensate for the increased blood glucose levels, fetal pancreatic beta cells can undergo hyperplasia. The rapid division of beta cells results in increased levels of insulin being secreted to compensate for the high blood glucose levels. Following birth, the hyperglycemic maternal blood is no longer accessible to the neonate resulting in a rapid drop in the new born’s blood glucose levels. As insulin levels are still elevated this results in hyperinsulinemia. To treat the condition, high concentration doses of glucose are given to the neonate as required maintaining normal blood glucose levels. The hyperinsulinemia condition subsides after one to two days.

Causes

• Neoplasm, pancreatic cancer, PCOS, Trans Fats

Effects

• May lead to hypoglycemia or diabetes
• Increased risk of PCOS
• Increased synthesis of VLDL (hypertriglyceridemia)
• Hypertension (insulin increases sodium retention by the renal tubules)
• Coronary Artery Disease (increased insulin damages endothelial cells)
• Increased risk of cardiovascular disease
• Weight gain and lethargy (possibly connected to an underactive thyroid)

Symptoms

There are often no visible symptoms of hyperinsulinemia unless hypoglycaemia (low blood sugar) is present.

Some patients may experience a variety of symptoms when hypoglycaemia is present, including:

• Temporary muscle weakness
• Brain fog
• Fatigue
• Temporary thought disorder, or inability to concentrate
• Visual problems such as blurred vision or double vision
• Headaches
• Shaking/Trembling
• Thirst

If a person experiences any of these symptoms, a visit to a qualified medical practitioner is advised. Internet information does not substitute for advice by a medical professional, and diagnostic blood testing may be required.

Treatment

Treatment is typically achieved via diet and exercise, although Metformin may be used to reduce insulin levels in some patients (typically where obesity is present). A referral to a dietician is beneficial. Another method used to lower excessively high insulin levels is organic Cinnamon as was demonstrated when supplemented in clinical human trials.

A healthy diet that is low in simple sugars and processed carbohydrates, and high in fiber, and vegetable protein is often recommended. This includes replacing white bread with whole-grain bread, reducing intake of foods composed primarily of starch such as potatoes, and increasing intake of legumes and green vegetables, particularly soy.

Regular monitoring of weight, blood sugar, and insulin are advised, as hyperinsulinemia may develop into diabetes mellitus type 2.

Common misconceptions

• Due to the high levels of insulin, some people may believe that increased sugar intake is the answer. This is however counterproductive, since the excess production of insulin is due to insulin resistance; the body cannot effectively use the insulin produced.

• Hyperinsulinemia is often mistaken for diabetes or hypoglycaemia. These are separate, albeit related, conditions. Treatment may overlap for these conditions, but medical advice should always be sought.

See also

• Metabolic syndrome(Syndrome X)

External links

• MayoClinic
• Jewish Hospital, Cincinnati
• ped/1075 at eMedicine