(the following Prevention.Com magazine article also mentions PCOS)
Insulin Resistance Syndrome:
The New Silent Killer
One in four Americans--47 million people--are at risk for Insulin Resistance Syndrome (IRS), a sort of silent, lurking "early diabetes" that raises your odds for heart attack, stroke, full-fledged type 2 diabetes, infertility, certain cancers, and liver disease. But you can't feel it or see it--and your doctor may not test you for it. That's the shocking news announced on August 26 in Washington, DC, by the American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE).
All that is about to change. The doctors and experts who gathered in Washington have released the first-ever US guidelines for finding and controlling this silent killer. Your family doctor or gynecologist will be hearing about this lifesaving advice in the next few months. But don't wait! Prevention interviewed one of the nation's leading experts on IRS to find out what you can do about it--even before your family doctor hears the news.
"Insulin Resistance Syndrome underlies some of the most deadly and costly diseases in the US, so early intervention is critical," says Daniel Einhorn, MD, FACE, co-chairman of the ACE/AACE Insulin Resistance Syndrome Task Force and medical director of the Scripps Whittier Institute for Diabetes. The number of Americans with it has skyrocketed 61% in the past decade, thanks mostly to our epidemic of obesity and inactivity, he says.
The good news: You can slash your risk for IRS by simply losing a few pounds and exercising--walking, dancing, aerobics, anything active--for as little as 15 to 20 minutes a day, Dr. Einhorn says. "You can take control of this with simple lifestyle changes."
What You Need to Know
Insulin resistance happens when cells throughout your body somehow lose their ability to "listen" to insulin, the vital hormone that's responsible for ushering blood sugar out of the bloodstream and into cells, where it's used as energy. In the past, doctors didn't measure insulin resistance, or try to control its consequences, until damage had been done.
In IRS--also sometimes called metabolic syndrome, or Syndrome X--you also have unhealthy levels of cholesterol and triglycerides, key blood fats that can raise heart attack and stroke risk.
Are You at Risk?
The more of these risk factors you have, the greater the chance you have IRS:
Overweight. A Body Mass Index (BMI) higher than 25, or a waistline that measures more than 40 inches for men and 35 inches for women.
A sedentary lifestyle.
Over age 40.
Non-Caucasian ethnicity. Latino/Hispanic American, African American, Native American, Asian American, Pacific Islander
A family history of type 2 diabetes, high blood pressure, or cardiovascular disease.
A history of glucose intolerance. A score between 110 and 125 on a fasting plasma glucose test. Or, for women, a history of gestational diabetes during pregnancy.
A diagnosis of high blood pressure (130/80 or higher), elevated triglycerides (higher than 150)/low HDL cholesterol (less than 50 for women, less than 40 for men), or cardiovascular disease.
Acanthosis nigricans. These are patches of thick, brownish, velvety skin at the neck, underarms, or groin.
Polycystic ovary syndrome. This condition reduces a woman's fertility.
What If You're Not Sure You Have IRS?
If you think you may have IRS but aren't certain, ask your doctor for the gold-standard check: a glucose tolerance test. "This is an old, inexpensive test that is our best check for insulin resistance," Dr. Einhorn says. "Every family doctor and gynecologist knows how to administer it." For the test, you'll be asked to drink a sugary beverage (often orange flavored) containing 75 g of glucose (sugar). A blood test 2 hours later shows how well your body handles the sugar, giving a picture of whether or not your cells are listening to insulin's signal to absorb blood sugar. A score of 140 mg/dL or higher indicates insulin resistance.
Get IRS Under Control
Right now, the best way to control or prevent IRS is by taking small, steady steps toward a healthier lifestyle. "We really don't have enough evidence today to say that you can treat insulin resistance pharmacologically [with drugs]," Dr. Einhorn says.
In contrast, there's strong evidence that losing weight and getting fit do help. "About half of the risk of insulin resistance comes from lifestyle, from being overweight and sedentary," he says. "The rest is genetic. What you do at home can have a huge impact."
Here are Dr. Einhorn's top tips:
Lose a little weight.
Dropping 5 to 10% of your body weight can improve insulin sensitivity, meaning your cells regain their ability to "listen" to insulin's signals.
Move more.
Exercise can help you lose weight, and it also seems to work on its own to improve insulin sensitivity, he says. "As little as 15 to 20 minutes of walking a day can help. And more is even better." (Prevention recommends 30 minutes of exercise at least 5 days a week, and 45 minutes to an hour a day at least 5 days a week if you're trying to lose weight.
Get checked and rechecked.
Are your efforts paying off? Find out by getting your blood sugar, cholesterol, and triglycerides measured after 3 to 6 months.
Try fun multi-tasking.
If you're crazy busy with your job, family, household responsibilities, and social life, try combining a family or social activity with fitness, Dr. Einhorn suggests. "Take your child out in the stroller for a half-hour walk, and talk and sing together," he suggests. "Walk or exercise while you watch TV. The key is, make it fun, and make it fit into your life. When my kids were little, I would carry them in a child-carrier backpack and take walks. They still remember it. We had a great time!"
Prevention Mag article on IR & testing 
