Insulin is a protein involved with carbohydrate metabolism and is associated with the characterization of Atherogenic Lipid Profile and Metabolic Syndrome. It is elevated postprandially in proportion to the carbohydrate content in a meal. The loss of estrogen at menopause is also associated with increased insulin levels.

Clinical Implications:

Hyperinsulinemia is a clinically important marker for patients who have a family history of diabetes or who have slightly elevated blood glucose levels without other symptoms of diabetes. Abnormal fasting insulin (≥25 ľU/ml), especially when combined with other risk factors, identifies patients at significantly higher risk for the development of cardiovascular disease. A continuous hyperinsulinemic state can impact the body's ability to utilize stored energy effectively, thus hampering weight loss.

Treatment considerations:

• Common pharmacological methods of meeting insulin requirements or regulating insulin sensitivity:
  • Metformin
  • Thiazolidinedones (rosiglitazone or pioglitazone)
  • Acarbose
  • Glipizide/glyburide
  • Fibrates (fenofibrates)
• Lifestyle changes:
  • Fat-restricted, cardioprotective diet
  • Limit simple carbohydrates, utilize high fiber sources
  • Weight loss
  • Regular exercise

For more information, please refer to our Clinical Implications Reference Manual.