Hyperinsulinemia: Diagnostic and Treatment Considerations

*Caralise W Hunt
College Of Nursing, Auburn University, Auburn, Alabama, United States

*Corresponding Author:
Caralise W Hunt
College Of Nursing, Auburn University, Auburn, Alabama, United States
Email:Huntcar@auburn.edu

Published on: 2022-12-05

Abstract

Hyperinsulinemia may be the first indicator of developing metabolic disease and has been linked to insulin resistance, obesity, prediabetes, and type 2 diabetes. Diagnosis of hyperinsulinemia is complex, as signs and symptoms may not be present until other metabolic abnormalities have developed. Formal testing guidelines and a standardized approach to testing for hyperinsulinemia are needed. Practitioners can recommend and emphasize the importance of lifestyle modifications to prevent hyperinsulinemia and subsequent metabolic disease.

Keywords

Hyperinsulinemia; insulin resistance; Obesity; Type 2 Diabetes

Introduction

Hyperinsulinemia and insulin resistance are two separate conditions, yet they are inextricably linked. Hyperinsulinemia is considered a compensatory response to insulin resistance. As cells are repeatedly exposed to large amounts of glucose, they become insulin resistant leading to an increase in insulin secretion and eventual hyperglycemia when beta cells fail to produce enough insulin. However, animal and human studies suggest that increased insulin secretion in response to overnutrition is actually the first event that then progresses to obesity and insulin resistance followed by type 2 diabetes (T2D) [1-4]. This model of diabetes development indicates that hyperinsulinemia, rather than glucose alterations, maybe the earliest sign of metabolic disease [2].
Data regarding the prevalence of hyperinsulinemia are limited. An analysis of 1999-2018 National Health and Nutrition Examination Survey (NHANES) data revealed rates of hyperinsulinemia increased by ~18% during that time period. When divided into time segments of 1999 to 2010 and 2010 to 2018, an increase of approximately 65% occurred in the first segment and a decrease of 29% was noted in the second segment, though the decrease did not reach the level of significance. Researchers theorized that the decrease may be related to improved medication regimens and lifestyle modifications [5].
The metabolic consequences of hyperinsulinemia justify the need for standardized diagnostic testing and clinical treatment guidelines. Hyperinsulinemia has been linked with the development of health conditions including T2D, obesity, dyslipidemia, hypertension, and cardiovascular disease [2-4,6-8]. Guidelines for the diagnosis and treatment of hyperinsulinemia in adults are not available. As a result, detection of developing the metabolic disease before the cascade of events leading to insulin resistance, metabolic syndrome, and T2D occur is delayed. The purpose of this review is to present a synthesis of the literature on the role of hyperinsulinemia in the development of subsequent metabolic disease and provide evidence-based recommendations for interventions to decrease insulin levels in adults.

scroll up