What Is Insulin Resistance Index Test
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The definition of the HOMA index (homeostatic assessment of the insulin resistance model) is a type of blood test for the body's resistance to insulin. During laboratory analysis of a blood sample, the patient concentrated insulin on fasting and glucose. Based on the obtained results, the NOMA index - a marker of insulin resistance is calculated.
The IR indicator NOMA is an indicator of the development of disorders of glucose tolerance in the body and, as a result, diabetes in the future. It is also used to calculate the risk of developing metabolic syndrome.The optimal value of HOMA-IR should not exceed 2.7. Fasting glucose, which is used to calculate the index, varies depending on the person's age:
At the age of fewer than 14 years, the indicators range from 3.3 to 5.6 mmol / l;Deviations from the norm
The HOMA index rose to 2.7. An increase in indicators may also indicate the presence of pathology. Physiologically, the insulin resistance index may increase if blood donation conditions are not met for analysis. In such a situation, the analysis is reviewed and the indicators are re-evaluated.
Diet therapy is one of the key points in the treatment of insulin resistance.
Insulin insensitivity therapy aims to reduce body fat. If the NOMA index has risen, it is highly recommended to adjust your daily diet. Be sure to reduce the number of fats and carbohydrates consumed. Baking, sweets, fried foods, pickles, smoked meats, dishes high in spices are completely excluded. The use of vegetables, lean meat (chicken, turkey, rabbit), and fish is recommended. The best ways to cook meals:
It is necessary to eat fractionally - 5-6 times a day. In addition, it is recommended to drink 1.5-2 liters of clean water a day. Coffee, strong tea, alcohol must be completely excluded from consumption. In addition, patients with insulin resistance are recommended to do sports: running, yoga, swimming. Be sure to do morning exercises. The required lifestyle is determined by the attending physician individually.
Indications for NOMA analysis
This type of blood test is prescribed for:
Assessment of the possibility of the patient developing diabetes and diseases of the cardiovascular system - ischemia, arterial hypertension, and ischemic stroke;
Diagnosis of insulin resistance in patients with chronic renal failure, polycystic ovaries, hepatitis B and C;
Additional diagnosis for some infectious diseases;
Assessment of the patient’s condition while taking a range of medications.
GENERAL RULES OF PREPARATION FOR BLOOD ANALYSIS
It is recommended to drink 1-2 glasses of still water just before taking blood, this will help collect the amount of blood needed for testing, reduce blood viscosity and reduce the likelihood of clot formation in the test tube. It is necessary to exclude physical and emotional stress, smoking 30 minutes before the study. Blood for research is taken from a vein.
Content of HOMA index data in the identification of insulin resistance, preparation for the study, indications, the first signs of the disease, and treatment
The HOMA index is a diagnostic method for calculating insulin hormone resistance, which is used for the early detection of diabetes. In this article, we will explore what insulin resistance is - how to determine pathology.
Attention! This is not the only diagnostic method. If you suspect diabetes, consult a specialist.
NOMA index method
The method calculates simultaneously measured levels of insulin and glucose, which are determined on an empty stomach. From this, beta-cell function and insulin sensitivity can be calculated. This approach is currently well known in clinical diagnosis.
The NOMA method is based on a relatively simple model of the mathematical feedback interaction of insulin and glucose in the homeostasis of carbohydrate metabolism.
Many ask: how to take the analysis? A blood test for insulin resistance is taken strictly on an empty stomach. No special preparation is required, but it is not recommended to engage in great physical effort before the examination, because they can lower blood sugar. It is necessary to prepare for the examination according to the recommendations of experts.
The first signs of insulin resistance
The initial symptom of insulin resistance may be an increase in body weight as a result of an increase in insulin concentration in the blood. Insulin is the only hormone that accumulates fat in the body (adipogenic effect). Many diabetics have a genetic predisposition to develop insulin resistance. It is currently believed that belly fat releases hormonally active substances that further promote and increase insulin resistance.
Triglyceride insulin resistance may be indicated by concentration. At triglyceride levels above 2.44 mmol / L, there may be hormone resistance.
In the pancreas, the proinsulin molecule of the molecule precursor is first synthesized. Hormonal insulin is produced only by cleavage of the so-called C-peptide. In addition to insulin resistance, a lot of insulin is produced, which also indicates a high level of proinsulin in the blood.
Insulin resistance is the primary distinguishing feature of T2DM. The reason is a persistent diet high in carbohydrates and constant excessive consumption of sugar, which leads to an increase in insulin levels in the blood and increases the risk of obesity. The exact mechanisms that lead to insulin resistance are being intensively studied, as the costs of diabetes are significant and rising.
Initially, resistance does not cause special symptoms. For this reason, it is often diagnosed only when serious complications occur. The symptoms are similar to those of diabetes: dry skin, blurred vision, and impaired wound healing. Possible accompanying symptoms are fatigue, poor concentration, and muscle weakness.
Physical and mental performance decline, so patients often suffer from problems in daily life. Insulin resistance can cause muscle dysfunction and severe muscle weakness. In some cases, there is serious weight loss.
High blood sugar levels generally cause a severe thirst, which is accompanied by frequent urine. Other signs include high cholesterol and low HDL.
In the initial stage, the disorder is not manifested by visible external signs. Only in rare cases can the typical symptoms of the disease appear - weight problems, pale skin, and sweating. In the long run, resistance can cause major complications. Patients develop cardiovascular and renal diseases, which often lead to irreversible consequences.
Constant use of simple sugars makes the body insensitive to insulin. In obesity, leads to an increase in the content of free fatty acids, which in turn stimulates the liver to produce more sugar.
As for exercise burns sugars and fats, lack of exercise reduces the body’s ability to use it. Obesity due to excessive calorie intake in the form of simple sugars combined with physical inactivity is a major cause of insulin resistance.
Other main causes of insulin resistance:
- Medicines
- Severe infectious diseases;
- Metabolic disorders - hypertriglyceridemia;
- acromegaly;
- Polycystic ovary syndrome;
- Persistent malnutrition;
- Lipodystrophy, Rabson-Mendenhall syndrome, Lawrence syndrome.
- Resistance increases due to:
- Abnormal insulin prescriptions;
- Decreased number of receptors with constantly elevated insulin levels;
- IgG - antibodies that inhibit the biological activity of insulin;
- Increased enzymatic degradation of insulin;
- Decreased efficiency of insulin binding to its receptors;
- Insulin-resistant proteins, such as tumor necrosis factor-alpha (TNF-alpha) and plasminogen activator inhibitors, type I (PAI-1).
- HOMA indicators and calculation
Calculation of different HOMA indices:
HOMA Beta: 20 * fasting insulin concentrations (mU / l) / (head glucose levels (mmol / l) - 3.5);
HOMA IR: empty stomach insulin level (mU / l) * glucose at time (mmol / l) / 22.5.
The norm for men and women is not different and is 4.1-5.9 mmol / l. Deciphering the results should be performed by a qualified physician.
Treatment of insulin resistance disease
First, the doctor changes the patient’s diet. The use of untested diets with medications is not recommended. It is better to switch a person to a whole but non-fat diet with whole grains and vegetables.
It is important not only to reduce simple sugars several times but also fats - especially animal fats. Another important component of treatment is to increase the patient's physical activity. All endurance sports are suitable. People who are overweight or obese should try to lose weight for any type of diabetes or insulin resistance.
Insulin resistance can be treated with medication. In this case, metformin is used, which acts on the liver and reduces sugar production. Metformin lowers blood sugar and improves pancreatic function. Other drugs include insulin sensitivity, which improves cell sensitivity to insulin, and acarbose, which inhibits the absorption of sugar in the gut.
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