Many different conditions can affect the body’s ability to produce and process insulin, the hormone that regulates blood sugar levels. One such condition is hyperinsulinemia or overproduction of insulin. Although hyperinsulinemia on its own is not diabetes, it can lead to type 2 diabetes and another condition called hypoglycemia, which can have potentially serious consequences.

Despite that, hyperinsulinemia remains largely unknown and often misunderstood. This article covers everything you need to know about the condition, explaining what it is, what causes it, the complications it can lead to, and how it can be prevented and treated.

What is hyperinsulinemia?

Hyperinsulinemia is a condition that occurs when the pancreas produces too much insulin. If your body is not reacting to insulin in the way that it should, then your pancreas will make extra insulin to compensate.

However, that does not solve the problem because the body responds incorrectly to that too, thus creating a cycle in which more and more insulin is being made, which leads to hyperinsulinemia. Ultimately, your pancreas simply cannot keep up with the amount of insulin required to regulate your body’s blood sugar level.

Hyperinsulinemia is often confused with another condition called hyperinsulinism, which occurs when there is too much insulin in someone’s blood as a result of a malfunctioning pancreas.

Is hyperinsulinemia the same as diabetes?

No, hyperinsulinemia is not diabetes. However, because the condition is related to issues with producing and processing insulin it can lead to high blood sugar, which can then cause prediabetes and, ultimately, type 2 diabetes. Over 84 million adults in the United States have prediabetes, which suggests that the prevalence of hyperinsulinemia is very high.

What causes hyperinsulinemia?

Most medical authorities agree the main cause of hyperinsulinemia is insulin resistance, i.e., the body not responding properly to the insulin that it naturally produces. However, some recent research has suggested that it is hyperinsulinemia that causes insulin resistance (rather than the other way around).

Other potential, rarer causes of hyperinsulinemia include insulinoma, which is a tumor of the cells in the pancreas that produce insulin, and nesidioblastosis, a condition in which the pancreas makes too many insulin-producing cells. Hyperinsulinemia that is caused by either insulinoma or nesidioblastosis can lead to hypoglycemia (see below under complications for more information about this).

There also appears to be a possible link between gastric bypass surgery and hyperinsulinemia. Researchers are still not sure why this might be the case, but it could be because the cells in the pancreas are too active for a body that has changed shape following the surgery.

What other complications are linked to hyperinsulinemia?

If you have hyperinsulinemia without insulin resistance, it can also cause another condition called hypoglycemia, which is when your body has abnormally low levels of blood sugar. Hypoglycemia can lead to very serious health consequences, including seizures, coma, and problems with cognitive functioning (which particularly affect children suffering from the condition).

Other conditions that are linked to hyperinsulinemia include the following:

  • Hypertension (high blood pressure)
  • Atherosclerosis (hardening of the arteries)
  • Metabolic syndrome (a group of conditions that increases the risk of diabetes)
  • High levels of triglyceride (which can increase the risk of heart attack or stroke)
  • Hyperuricemia (high levels of uric acid)
  • Obesity (a body mass index (BMI) of 30 or over)
  • Polycystic ovary syndrome (excessive production of hormones in the ovaries)

What are the symptoms of hyperinsulinemia?

Hyperinsulinemia on its own does not have any symptoms that you would notice. But if it leads to hypoglycemia, then it can cause the following symptoms:

  • Excessive hunger
  • Cravings for sugar
  • Unintended weight gain
  • Problems concentrating
  • Feelings of panic and anxiety

If you suspect that a child or an infant has hypoglycemia, then the symptoms to look out for are as follows:

  • Problems feeding
  • Being very lethargic (i.e., having no energy)
  • Being extremely irritable

What are the risk factors for hyperinsulinemia?

Genetic factors affect your chance of developing hyperinsulinemia, meaning that if there is a history of the condition in your family, there is more chance of you getting it too.  Research from 2019 also found that Hispanic and Black children are more likely to develop hyperinsulinemia because of racial differences in the ways in which their bodies secrete and clear insulin.

Other factors that affect your likelihood of developing hyperinsulinemia include your socioeconomic status, diet, and exposure to pollution. People who are obese or who have hypertension (high blood pressure) or excessive visceral fat are also more likely to develop hyperinsulinemia.

How is hyperinsulinemia diagnosed?

Hyperinsulinemia is difficult to diagnose because it does not have noticeable symptoms and there is no one test that can be used to check for it. If doctors suspect hyperinsulinemia, they will try to assess a range of factors by doing a physical examination, asking questions about your medical history and family history, and looking for evidence of any signs that could be related to hyperinsulinemia. If a doctor does decide to do a blood test to gather extra evidence for the diagnosis, then the sort of test that they will normally administer is one that requires fasting for 8 to 12 hours before the blood is taken.

How can hyperinsulinemia be treated?

The good news is that hyperinsulinemia can be treated, and the earlier it is diagnosed the more likely it is that the treatment will be successful and you will not develop serious complications.

The type of treatment used for hyperinsulinemia depends upon its cause, which can be insulin resistance, nesidioblastosis, or insulinoma. Depending on the cause, the treatments used typically focus on either increasing the body’s sensitivity to insulin, maximizing its ability to clear insulin, or reducing the number of calories that the patient is consuming. Dietary changes to address hyperinsulinemia focus on supporting the patient to transition to a balanced diet consisting of foods that are rich in nutrition.

Dietary changes can also help to manage the blood sugar levels of a person living with hyperinsulinemia. For example, doctors might recommend the adoption of a low-fat, low-carbohydrate, or Mediterranean diet that focuses on foods that are low on the glycemic index (which measures the extent to which foods cause spikes in blood sugar levels.

If you are trying to change your diet to decrease the risk of hyperinsulinemia, you should try to avoid eating too many carbohydrates (which increase insulin production) and also avoid sugar, red meat, unhealthy fats, and processed starches.

Can exercise help to treat hyperinsulinemia?

Yes, physical activity can be a good way to address hyperinsulinemia because any exercise can lead to improvements in how your body deals with insulin. Exercise also produces extra benefits because it can also, when combined with a good diet, help to reduce obesity, which is one of the potential causes of hyperinsulinemia.

Any form of exercise can help to tackle hyperinsulinemia, including resistance exercises (such as weightlifting), aerobic exercise (such as walking or running), or high-intensity interval training (which involves moving between blasts of intense activity and short stints of rest).

Are there any medications that can be taken for hyperinsulinemia?

The normal first course of action for treating hyperinsulinemia is lifestyle changes. However, doctors may prescribe medication to reduce the risk of developing hypoglycemia or to tackle the type 2 diabetes that can be associated with hyperinsulinemia.

One drug that is frequently prescribed to reduce the likelihood of hypoglycemia and address type 2 diabetes is metformin.

As with any medication, it’s important to check with your doctor to make sure you are taking the right tablets for your condition. Some medications prescribed for other conditions can also make hyperinsulinemia worse, so it’s important to check that nothing that you are taking for anything else is having that negative impact.

Are there any other treatment options for hyperinsulinemia?

Bariatric surgery is sometimes used as a treatment for people with severe, class III obesity (formerly known as morbid obesity). People who have bariatric surgery often find that they no longer suffer from hyperinsulinemia, with the condition normally disappearing within one week of having the procedure.

However, bariatric surgery is only used in serious cases of obesity, and even then it is not suitable for all people. Also, as noted above, some research evidence suggests that bariatric surgery can also cause hyperinsulinemia in some cases.

Conclusion

So, as we have seen hyperinsulinemia is not diabetes, but it is closely associated with it. That’s because it affects the function of the pancreas and ultimately impacts the amount of insulin that the body produces. Hyperinsulinemia does not have symptoms on its own, but it can lead to hypoglycemia (unusually low levels of blood sugar) and type 2 diabetes.

The good news is that the risk of hyperinsulinemia can be managed by eating a healthy diet and taking regular exercise. Diet and exercise can also help to treat the condition and prevent the likelihood of further complications developing.

As always, please consult your doctor or another medical professional if you have questions or concerns regarding hyperinsulinemia. Doctors can also advise on the best treatment options for your specific circumstances, including the diet and exercise plans that will work best for you.