19 February

Obesity,infertility and insulin resistance

If you have to get inside a locked house - What do you need? Keys to open the door. Similarly, there is a key which needs to be used for the glucose in the food you eat to get into the muscle cell, liver cells and all the other cells in the body. The key to all these cells is the Insulin released by the pancreas which is present in the blood cells. Once the key is turned in - the gates of the cells open allowing the entry of glucose, which is then utilized by the cells for the production of energy. 

Recent times increasing obesity, diabetes incidence is increasing insulin resistance in our bodies. Insulin resistance is when these muscles cells, liver cells and fat cells develop a resistance to insulin present in the blood. So insulin although present in the blood is not able to open the gate, and thus the glucose begins to build up in the blood and because there is his glucose build up in the blood, Pancreas( whose job is to release insulin when it detects excess glucose in the blood) release more insulin and thus the cycle continues.

Today we will be looking at how increase insulin resistance is going to affect fertility in a woman?

Insulin resistance contributes to infertility through a number of mechanisms.

  • Excess insulin shifts the sex hormone balance to promote testosterone(seen more in males) production over estrogen production
  • It also can inhibit ovulation
  • Egg quality in the presence of insulin resistance can also be compromised. A lower quality egg could mean poor outcomes, including delayed embryonic development, growth restriction of the fetus, birth defects, and smaller fetuses.

 How is it diagnosed?

Women at risk of insulin resistance are women who are obese, who have been diagnosed with PCOD, or woman with diabetes. There is no conclusive test to diagnose Insulin resistance but, increased fasting blood sugar, increased HB1AC levels could indicate the presence.

How do we reduce insulin resistance?

  • Exercise is known to be very good at decreasing insulin resistance. Exercise especially strength training can cause increased muscle mass and also the efficiency of the muscle to utilize the glucose present in the blood. We can think of exercising as kind of repairing our cell key holes making it more sensitive to insulin in the blood and thus decreasing the blood glucose. Less insulin is needed to maintain blood glucose levels and this decreases insulin resistance. Exercise also decreases the levels of stress hormones, helps in losing weight and enhance sleep quality.
  • Lowering our stress hormones - Stress causes the release of stress hormones called cortisol. Increased cortisol levels cause increased blood sugar levels and increase insulin resistance. Decreasing cortisol levels can reverse the effect. So how do we reduce the cortisol levels? By being stress-free. Laugh and live happily. Practice meditation. Meditation and deep breathing are known to decrease the levels of stress hormones and thus help in decreasing the insulin resistance too.
  • Improving sleep quality - Good sleep is known to be restorative. Cultivate a good sleep routine. Disturbances in the circadian rhythm are known to cause increased stress hormone levels and thus causing increased blood sugar levels.
  • Increase your intake of soluble and insoluble fibre. This will help slow the absorption of sugars and can lower the amount of insulin released
  • Patients with insulin resistance who are trying to get pregnant are often given metformin, an insulin-sensitizing drug. Metformin makes the liver more sensitive to insulin so it absorbs more glucose from the bloodstream

So if you are considering getting pregnant or have been trying to get pregnant and have not been successful - Pause and look at the above measures and see if you have been doing everything that is in your control - Take  a look at your lifestyle and see if you could make any positive changes and give nature a chance to correct before you see your doctor.

Last modified on Friday, 01 March 2019 14:02
Dr Padma

Dr Padma is a Family care physician and is the Founder and CEO of MedHealthTV.


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