Insulin resistance: the warning sign many Malaysians miss

Many people associate diabetes with high blood sugar levels, medication and dietary restrictions. What fewer people realise is that long before diabetes develops, the body often gives subtle warning signs that something is wrong.

One of the most common is insulin resistance, a condition that occurs when the body’s cells become less responsive to insulin, forcing the body to work harder to keep blood sugar levels under control.

According to Dr Norlaila Mustafa, a senior consultant in medicine and endocrinology, insulin resistance is particularly common among people living with obesity.

“Almost all individuals with obesity experience insulin resistance, but that does not necessarily mean they have diabetes,” she told Bernama.

“Insulin resistance is actually the early stage that may eventually lead to diabetes if left uncontrolled.”

Norlaila explained that insulin acts like a key, helping sugar move from the bloodstream into the body’s cells, where it is used for energy.

When insulin resistance develops, that process becomes less effective, causing the body to produce more insulin in an attempt to compensate.

The condition usually develops gradually rather than appearing overnight. Unhealthy eating habits, physical inactivity and weight gain are among the main contributors, although stress and poor sleep can also play a significant role.

Norlaila noted that chronic stress increases levels of the hormone cortisol, which can interfere with metabolism, while insufficient sleep is closely linked to weight gain and metabolic problems.

Left unmanaged, insulin resistance can increase the risk of developing diabetes, heart disease and high blood pressure.

More concerningly, it often develops without any obvious symptoms. Still, Norlaila said there is one physical sign that is frequently overlooked: darkened patches of skin around the neck, elbows, knuckles or body folds – a condition known as acanthosis nigricans.

“Many people assume it is dirt or poor hygiene, but it is actually one of the signs of insulin resistance,” she said. “We commonly see it among individuals who are overweight.”

While obesity remains one of the strongest risk factors, Norlaila stressed that insulin resistance can also affect people who appear slim or maintain a normal weight, particularly if they have a genetic predisposition.

She also cautioned against the frequent consumption of highly processed food, as “they contain high levels of fat, and fat cells produce hormones that lead to insulin resistance”.

The good news, she said, is that preventing and managing insulin resistance often begins with simple lifestyle changes. Regular physical activity, maintaining a healthy weight and making more mindful food choices can all help reduce risk.

“It does not mean you only need to eat vegetables,” Norlaila said, “but try to reduce foods high in sugar, salt and processed ingredients.”

She also encourages people to stay active through manageable forms of exercise such as brisk walking for at least 30 minutes a day.

“Above all, we must practise a healthy lifestyle through regular exercise and proper nutrition,” she added.

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