Hyperinsulinemia

What is hyperinsulinemia?

Hyperinsulinemia happens when you have a higher amount of insulin in your blood than what's considered normal. Insulin is a hormone your pancreas makes and releases that’s essential for life and for regulating blood glucose (sugar) levels, specifically by lowering glucose levels.

In most cases, hyperinsulinemia results from insulin resistance, which happens when cells in your muscles, fat and liver don’t respond as they should to insulin. The development of insulin resistance typically increases insulin production (hyperinsulinemia) so that your body can maintain healthy blood sugar levels.

If a person has excess insulin in their body and doesn’t have insulin resistance, it would cause low blood sugar (hypoglycemia). In the case of hyperinsulinemia due to insulin resistance, excess insulin doesn’t cause low blood sugar.

Chronic insulin resistance and hyperinsulinemia can result in chronic high blood sugar (hyperglycemia), which leads to prediabetes and Type 2 diabetes.

Due to the similarity in their names, people often confuse hyperinsulinemia with hyperinsulinism. Hyperinsulinism is a different condition that happens when a person has excess insulin in their blood due to an issue with their pancreas. This could be a tumor that produces excess insulin called an insulinoma or a congenital condition (a condition you’re born with) in which a gene mutation causes excess insulin production. Unlike hyperinsulinemia, hyperinsulinism causes low blood sugar.

Who does hyperinsulinemia affect?

Hyperinsulinemia caused by insulin resistance can affect anyone, and it can be temporary or chronic. The two main factors that seem to contribute to insulin resistance and hyperinsulinemia are excess body fat, especially around your belly, and a lack of physical activity.

How common is hyperinsulinemia?

Since there are no common tests to check for hyperinsulinemia and there are no symptoms until insulin resistance turns into prediabetes or Type 2 diabetes, the best way to measure the prevalence of hyperinsulinemia is through the number of prediabetes cases. More than 84 million adults in the United States have prediabetes. That’s about one out of every three adults.

How does hyperinsulinemia affect my body?

In addition to prediabetes and Type 2 diabetes, hyperinsulinemia is associated with the following conditions:

• Obesity.
• Metabolic syndrome.
• Polycystic ovary syndrome (PCOS).
• Higher triglyceride levels.
• High uric acid.
• Hardening of the arteries (atherosclerosis).
• High blood pressure (hypertension).

What are the symptoms of hyperinsulinemia?

You may have no noticeable symptoms of hyperinsulinemia that results from insulin resistance. This is because your pancreas is able to produce enough insulin to overcome the resistance. However, chronic insulin resistance and hyperinsulinemia often result in prediabetes and Type 2 diabetes.

Many people have no symptoms of prediabetes, often for years, but some people with prediabetes may experience the following symptoms:

• Darkened skin in your armpit or back and sides of your neck, called acanthosis nigricans.
• Skin tags (small skin growths).
• Eye changes that can lead to diabetic retinopathy.

Symptoms of Type 2 diabetes include:

• Increased thirst.
• Frequent urination (peeing).
• Increased hunger.
• Blurred vision.
• Headaches.
• Vaginal and skin infections.
• Slow-healing cuts and sores.

If you’re experiencing any of these symptoms, it’s important to see your healthcare provider.

What causes hyperinsulinemia?

Insulin resistance is the primary cause of hyperinsulinemia. Because your body is not using insulin properly with insulin resistance, your pancreas has to release extra insulin to try to keep your blood sugar levels in a healthy range.

How is hyperinsulinemia diagnosed?

Hyperinsulinemia can be tricky to diagnose since it often doesn’t have any symptoms unless it results in prediabetes or Type 2 diabetes. There’s also no common test to check for excess insulin levels specifically, especially since insulin levels can vary widely throughout the day.

Since there’s no single test that can directly diagnose hyperinsulinemia, your healthcare provider will consider several factors when assessing the condition, including your:

• Medical history.
• Family history.
• Physical exam.
• Signs and symptoms.
• Blood tests results, such as fasting plasma glucose (FPG) test results.

How is hyperinsulinemia treated?

Since not all factors that contribute to hyperinsulinemia can be treated, such as genetic factors and age, lifestyle modifications are the primary treatment for hyperinsulinemia. Lifestyle modifications include:

• Diet: Your healthcare provider or nutritionist may recommend avoiding eating excessive amounts of carbohydrates (which stimulate excess insulin output) and eating less unhealthy fat, sugar, red meats and processed starches. Instead, they’ll likely recommend eating a diet of whole foods that includes more vegetables, fruits, whole grains, fish and lean poultry.
• Exercise: Exercise lowers insulin levels and gradually increases insulin sensitivity, which can help treat hyperinsulinemia.
• Weight loss: Weight loss is associated with improvement in hyperinsulinemia, whereas weight gain is associated with worsening hyperinsulinemia. Treating obesity with lifestyle modifications, dietary changes, medication or bariatric surgery improves hyperinsulinemia.

Bariatric surgery for people with class III obesity results in a rapid correction of hyperinsulinemia within one week of surgery. In addition, insulin sensitivity improves between six and 24 months after surgery. However, not everyone is a good candidate for bariatric surgery. Talk to your healthcare provider about treatment options that are right for you.

Can hyperinsulinemia be reversed?

Insulin resistance — and the subsequent hyperinsulinemia — has several causes and contributing factors. Lifestyle changes, such as eating a healthy diet, exercising regularly and losing excess weight, can increase insulin sensitivity and decrease insulin resistance and hyperinsulinemia. But not all causes are reversible.

Talk you your healthcare provider about what you can do to best manage insulin resistance and hyperinsulinemia.

What are the risk factors for developing hyperinsulinemia?

Certain genetic and lifestyle risk factors make it more likely that you’ll develop hyperinsulinemia. Risk factors include:

• Having overweight or obesity, especially excess fat around your belly.
• Being age 45 or older.
• Having first-degree relative (biological parent or sibling) with diabetes.
• Having a sedentary lifestyle.
• Having certain health conditions, such as high blood pressure and abnormal cholesterol levels.
• Having a history of heart disease or stroke.
• Having a sleeping disorder, such as sleep apnea.
• Smoking.

What is the prognosis (outlook) for hyperinsulinemia?

The prognosis (outlook) of hyperinsulinemia depends on several factors, including:

• The cause of insulin resistance (which causes hyperinsulinemia).
• The severity of insulin resistance and hyperinsulinemia.
• How susceptible you are to developing secondary complications from insulin resistance and hyperinsulinemia.
• Adherence to treatment and your body’s response to treatment.

People can have mild insulin resistance and hyperinsulinemia that never turn into prediabetes or Type 2 diabetes. People can also have insulin resistance and hyperinsulinemia that’s reversible or very manageable with lifestyle changes.

If hyperinsulinemia results in Type 2 diabetes, it’s important to do your best to manage the condition to prevent possible complications.

When should I see my healthcare provider about hyperinsulinemia?

If you’ve been diagnosed with hyperinsulinemia or conditions related to insulin resistance and hyperinsulinemia, it’s important to see your healthcare provider regularly to make sure your blood sugar levels are in a healthy range and that your treatment is working.

If you’re experiencing symptoms of high blood sugar or prediabetes, contact your provider. They can run simple tests to check your blood sugar levels.

A note from Cleveland Clinic

Hyperinsulinemia is a potentially harmful condition that’s usually the result of insulin resistance. Since it doesn’t have any symptoms until it turns into prediabetes or Type 2 diabetes, the best thing you can do is try to prevent and reverse insulin resistance and hyperinsulinemia by maintaining a healthy weight, exercising regularly and eating a healthy diet.