Insulin Resistance

What is Insulin Resistance?

Insulin resistance means that the cells in your body have become less sensitive to the effects of insulin. Insulin is a hormone produced by the pancreas. It is secreted into the bloodstream and acts like a chemical messenger, instructing the cells of the body to open and receive glucose (sugar) from the blood. The cells turn this glucose into energy. If insulin levels are persistently high over a prolonged period of time, cells become resistant to insulin instructions. This provokes the pancreas to over-compensate by releasing even more insulin. This combination of insulin resistance and insulin over-production leads to 2 outcomes:

1. Prediabetes and eventually type 2 diabetes (adult onset diabetes). Or,
2. Obesity and high cholesterol, which raises your risk of heart disease.

What Problems Does Insulin Resistance Lead To?

Insulin resistance leads to two common outcomes:

(1) Over production of insulin wears the pancreas out so that insulin production slows down to abnormally low levels. Result? Prediabetes and eventually type 2 diabetes develops. Studies show that insulin resistance leads to type 2 diabetes in 30 percent of patients. Or
(2) The patient, although insulin-resistant, does not develop diabetes because the pancreas continues to be able to produce adequate amounts of insulin. Instead, they develop hyperinsulinemia - suffering abnormally high levels of insulin in the blood. Hyperinsulinemia can cause high blood pressure, low good (HDL) cholesterol, high levels of triglycerides, chronic obesity, heart disease and possibly some cancers. This combination of conditions is sometimes referred to as Metabolic Syndrome X or insulin resistance syndrome.

What Are The Symptoms Of Insulin Resistance?

There tend not to be outward signs of insulin resistance. A glucose tolerance test (see diabetes tests) which measures your blood glucose levels can help verify if you are insulin resistant. However, many people who are insulin resistant still produce enough quantities of insulin to keep their blood glucose levels near normal.

Some signs and symptoms, if they do occur, include:-

• Weight gain, particularly around the middle.
• Hunger
• Lethargy
• Brain fog, difficulties concentrating.

What Causes Insulin Resistance?

Research into insulin resistance and the other cluster of symptoms associated with Metabolic Syndrome X, have yet to determine a specific cause. Although insulin resistance is though to be largely hereditary, the main discussion point is why some people go on to develop diabetes or Metabolic Syndrome X and others do not. Lifestyle choices appear to be one obvious cause - in particular, obesity and lack of regular physical activity. One theory is that central obesity (fat around your mid-section) causes fat cells to become starved of oxygen and die. The body responds with an inflammatory response which sets off insulin resistance in other cells. Another theory is that over-consumption of foods high on the glycemic index set off a resistance.

How Is It Diagnosed?

Insulin resistance is diagnosed when 3 of the following elements are found:-

1. Raised blood pressure of 130/85 mmHg or higher.
2. Extra fat around the waist (called visceral fat). A large waist circumference is considered 35 inches (89 cm) or more for a woman and 40 inches (102 cm) or more for a man.
3. Fasting blood sugar (glucose) level of 100 mg/dL (5.6 mmol/L) or higher (see, what is a normal blood sugar count?).
4. Low HDL cholesterol (the 'good' cholesterol) levels. That is, under 50 mg/dL (1.3 mmol/L) for women and 40 mg/dL (1.04 mmol/L) for men.
5. Triglycerides levels of 150 mg/dL (1.7 mmol/L) or higher.

Can Insulin Resistance Be Reversed?

Yes, you may be able to decrease or halt the progression of insulin resistance by losing weight and changing your diet. Ideally follow a healthy Low GI diet which entails reducing your consumption of sugary foods and foods containing refined carbohydrates (like white bread, cookies, cakes and pastries); while increasing your intake of health carbohydrates from vegetables, fruits and beans. Studies suggest that cutting back on 'bad' carbs and increasing 'good' carbs in this way can improve insulin sensitivity. Also, aim to include 30 minutes of aerobic activity in your daily schedule (such as a brisk walk). Read more ... diabetes prevention.

Nutrition Tip

Omega 3 essential fatty acids play a role in helping to control insulin resistance and hormone disruption. Natural sources are hemp seeds, flax seeds and oily fish like sardines, salmon, herring, pilchards and anchovies.

• Need more information? See: Diabetes Guide
Hemoglobin A1C Test: Diagnosing diabetes.

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