Insulin Resistance (Nursing)

00:00 Hi, welcome to our video series on diabetes.

00:04 The question I have for you today is, what is insulin resistance? Well, it sounds deeper than it is, but it is an important concept for all nurses to know about.

00:15 Because it's an early warning sign.

00:18 Note the skull and crossbones. I put up there for you to remember.

00:22 Now, you've seen this slide before, because it's a critically important concept.

00:27 Insulin resistance happens right here during prediabetes.

00:31 Remember, this can last on an average of up to six and a half years.

00:36 And this is where we can make a difference.

00:38 So you understanding insulin resistance helps make you a more effective clinical decision maker.

00:45 I love this. Resistance is futile.

00:48 I told you I have a bit of a weird sense of humor, but anything that makes a concept stick in your mind, I'm willing to do it.

00:56 So in insulin resistance, insulin is present even elevated, but the cells just can't use the insulin to absorb the glucose for energy into the cells.

01:07 So the blood sugar rises, and rises, and rises.

01:11 You see, those are the three key points about insulin resistance and we're going to use them as an introduction to you now.

01:18 That will apply these three points at the end of the series again to help you see how much you've learned.

01:24 Okay, so let's start from the bloodstream.

01:26 I have some really fun illustrations for you in this.

01:30 So let's take a look at it.

01:31 Here is what a normal blood vessel would look like, right.

01:34 So you've got the layers on top and bottom and we've got what flows through the middle.

01:40 So we're going to start right here.

01:42 And let's break this down.

01:44 Now we're going to add the red blood cells.

01:47 It's like magic. See them right there? Those are the red discs.

01:51 Now I'm going to add white blood cells.

01:54 There you go.

01:55 Obviously, they are white discs.

01:57 Next up platelets.

02:00 Okay, these are representative of all the types of blood cells in your body.

02:05 Now, I know there's five different types of white cells, but work with me here.

02:09 So you've got red cells, white cells, and platelets.

02:13 This is what you normally see in the bloodstream.

02:16 All these cells are made by your bone marrow.

02:18 Next up, now look what's different in the bloodstream.

02:23 Those look like little cubes, because that's what they are.

02:26 We put that in there to remind you of blood sugar.

02:28 So think of them as like little sugar cubes.

02:31 Now, I know you know, that's not what they really look like.

02:34 But for the purpose of this graphic, it's going to help you think blood sugar.

02:38 So this is a relatively low blood sugar.

02:41 But look what happens when you eat a delicious meal.

02:45 There you go.

02:46 We've got a lot more glucose in the bloodstream.

02:50 So this is what a normal amount of glucose would look like after a meal.

02:54 So this is what's going to cause or trigger the pancreas to release insulin.

03:00 Whoa, what's different here? When I should see a lot of these gray type triangles.

03:08 So for a patient who doesn't have prediabetes, the pancreas will release the amount of insulin needed to lower the blood sugar.

03:15 And it's going to help the glucose get into the cells.

03:18 So look what you have here, the red cells, the white cells, the platelets, you have extra glucose because you've just eaten a meal.

03:27 And now you see the insulin that's been secreted by the beta cells in the pancreas to help control that blood sugar and get it into the cells for energy.

03:36 So what's different for a patient with insulin resistance? Let me show you.

03:43 Woah.

03:46 So somebody with insulin resistance has a lot of extra glucose and a lot of extra insulin.

03:54 Why? Because the insulin can't be used effectively.

03:58 We've got a problem.

03:59 I mean, look at the differences here.

04:02 Which one is prediabetes? Yeah, it's the one over here on the right hand side.

04:08 This is someone who clearly has developed insulin resistance.

04:12 Let's break down what the differences are.

04:14 Compared the red cells, white cells, platelets, those are about the same.

04:18 But I want you to look at the amount of glucose in the normal, and compare to prediabetes.

04:24 Look at the amount of insulin compared to the normal or nondiabetic client and the one with prediabetes.

04:31 Okay, that's a really graphic difference.

04:34 So, I wanted you to have a visual, so that's really solid in your mind.

04:39 Now we're going to review insulin resistance step by step.

04:43 Remember, the insulin is present, even elevated, the cells can't use the insulin to absorb the glucose for energy.

04:50 That's why you got so much glucose and insulin bumping around there.

04:54 So the result is blood sugar rises, and rises, and rises.