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Insulin resistance syndrome - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Diabetes
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1773 Questions
Doctor :   hi
Doctor :   how can i help u
Doctor :   please proceed with your query

User :   can we carry off from where i left
Doctor :   yes please proceed

User :   so basically i was asked to find out the sugar levels for my sister ,she has got her pp and fasting done both are normal ,though the insulin is high on her case and she has been put on metformin 1500mg
Doctor :   ok
Doctor :   wats her ht and wt
User :   height is 5 4 and weight should be 80 plus
Doctor :   ok
Doctor :   sorry to say she is obese
Doctor :   obesity is one of the common
Doctor :   cause for insulin resistance syndrome
Doctor :   even the sugar levels are normal
Doctor :   IRS has a genetic roleto play
User :   also can it also be related to her not getting her periods for last 10months without oral pills
Doctor :   insulin levels are high because the receptors are mutated or abnormal
Doctor :   so these receptors in tissue level are defective
Doctor :   so the insulin cannot act on it
Doctor :   the level of insulin becomes higher
Doctor :   is she married
User :   yes for one year now
Doctor :   ok
Doctor :   does she has kids
User :   no as mentioned earlier in her case history first she had maneourigia and then now amenorhia ,with irs and thyroid .she is really concerned and also was under depression in june /july/aug last year .had to be put on cipralex on doctor's advise which she is taking till now
Doctor :   ok
Doctor :   once obesity is under control
Doctor :   the IRS will improve
Doctor :   thyriod will function well
Doctor :   once thyroid is under good control
Doctor :   the depression will reduce
Doctor :   in hypothyroidsim depression is common
Doctor :   has she under gone D and C
Doctor :   dilatation and curratage of uterus
User :   what is D & C ,i dont understand ,could you please explain.her uterus is normal
Doctor :   i will do
Doctor :   as the scan was normal
User :   yes
Doctor :   the next step towards the cause of menstrual irregualrites to be found
Doctor :   its Dand C
Doctor :   its a minor procedure where they dilate the uterus and scape the walls of uterus
Doctor :   and the material is studied further
Doctor :   under microscopy
Doctor :   any abnormality will be regonised
Doctor :   and treatment accordingly
Doctor :   some times D and C itself helps in menstrual irreglularities
Doctor :   after this procedure the cycles will be regualr
Doctor :   its both for diagnosis and also for treatment
User :   is it a tissue culture ,because she has gone one when she was 16 or 17 ,it was all normal
Doctor :   its not a culture

Doctor :   its a examination under microscope
User :   i think it has been done for her ,after the same only the periods reduced .earlier she used to bleed heavily and cycles used to merge
Doctor :   ok
Doctor :   has the cholesterol levels checked
Doctor :   hormonal profile done
User :   need to check with her
Doctor :   ok
User :   yes ,all normal .estrogen ,other lipid profiles everything normal
Doctor :   ok
Doctor :   the root cause for all the condition is
Doctor :   obesity
User :   what should we advise her
Doctor :   once its under control the other problems will improve
Doctor :   let me give few good medical tips to reduce wt
Doctor :   and to improve IRS
Doctor :   1. diet
User :   how about her getting pregnant ,she is a housewife and wants to go in for a baby now
Doctor :   ok
Doctor :   1. diet
Doctor :   reduce or avoid fat, ghee, and other oily substance s
Doctor :   have plenty of green leafy vegetables, and fresh fruits
Doctor :   2. regarding exercise
Doctor :   yu need a brisk walk for half an hour
Doctor :   early morning every day
Doctor :   if possible twice a day
Doctor :   3. tab. Metformin has proved very much advantage in reducing IRS
Doctor :   to continue it and it also helps in wt reduction
Doctor :   i want to mention thing regarding depression
Doctor :   be sportive, mentally calm, and a good relationship with friends
Doctor :   its better to avoid Cipralex after few days
Doctor :   as it has more sideffects
User :   what are the sideffects
Doctor :   mood changes
Doctor :   minor contribution to obesity
Doctor :   please proceed
User :   she has been on it for 6 months now ,3 tablets per day .
Doctor :   ok
Doctor :   on long turn tiredness, sexual dysfunction, dry mouth
Doctor :   increased appetite
Doctor :   you can reduce the dosage and the number of times
Doctor :   times of taking medications
Doctor :   hi are yu there
User :   can she be off it completely in one shot
Doctor :   no not to do that

Doctor :   let it be a gradual with drawl
Doctor :   initially 2 times a day for 10-15 days
Doctor :   and once daily for another 10 days
Doctor :   and then yu can stop
User :   with regards to the menses what do you advsie
Doctor :   are yu on any pills
User :   no she is not
Doctor :   ok
Doctor :   when was the last period
User :   last year probably aug or sep
Doctor :   ok
User :   please advise
Doctor :   yes i will
Doctor :   regarding the harmonal profile
User :   also as a family member can also get a password for her so that she can log in directly and have a doctor appointed to her as a part of pilot
Doctor :   can yu send me the reports thru email
Doctor :   the first person information will be lot of help to us
User :   sure ,should not be a problem,would need to arrange for scanning the same
Doctor :   yes yu can get a pass word
Doctor :   we will help her and give good suggestions and further tests to be done
Doctor :   even regarding infertility some personal Q to be asked
User :   what is it that you foresee in this case ,is it all obesity related
Doctor :   Obesity the cause of IRS
Doctor :   there are other factors contributing to obesity
Doctor :   like tab. Cipralex, hypothyroidism,
Doctor :   and finally depression, IRS as a cause of infertility
Doctor :   i need to advice her further test regarding the
Doctor :   higher harmonal profile and challenge test
Doctor :   Is there any thing else i can help u with
Doctor :   hi are you there
User :   yes i am thought you were advising .also not mensurating does it mean she is infertile
Doctor :   menstration has not occured suggests that there is a abnormal or imbalance in the female sex hormones
Doctor :   thats the reason when ever yu take pills
Doctor :   she use to bleed ]
Doctor :   when stopped taking pills she didnt bleed
Doctor :   this suggests a sex harmonal imbalnce
User :   but does this mean infertility
Doctor :   as the ses harmone is required for fertility
Doctor :   its more towards infertiliy
User :   thanks doc ,will get the details on monday
Doctor :   infertility is defined as not getting pregnant even after 1 yr of marriage after having unprotected sexual intercourse
Doctor :   please fill the feed back form
User :   also would weight reduction in her case help
Doctor :   that is very very impotant
Doctor :   it will help to reduce IRS
Doctor :   so the fertility rate will improve
User :   thanks doc ,logging out now
Doctor :   ok bye for now take care
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