Insulin Resistance

What is insulin resistance? Let’s start by discussing normal physiology.

When you consume a carbohydrate-based food, say a piece of toast, it is broken down into glucose in your bloodstream.   This glucose needs to enter your cells in order to be converted into energy. Insulin, secreted by the pancreas, is the key which opens that cell to allow blood glucose to be converted into energy.

Insulin acts as the key which unlocks the cell to allow glucose to enter the cell and be used for energy

For example, if a nondiabetic consumes this piece of toast, they may only need one unit of insulin to activate the cell.

When someone is prediabetic, the cells are becoming resistant to the insulin produced. The pancreas may now need to secrete 2-3 units of insulin (for example) to then activate the cell.

In a person who is a type II diabetic, they may need, let’s say, 4+ units of insulin to activate the cell. The pancreas is working hard to make this happen and may exhaust over time. This is when exogenous insulin becomes necessary as your body can no longer produce sufficient insulin.

Type I diabetics, on the other hand, don’t typically have insulin resistance. Instead, their pancreas does not produce enough insulin in response to an elevation of blood sugar. It is possible to have a hybrid of type I and II diabetes, often termed type 1.5 or latent onset autoimmune diabetes of adults (LADA), where there is components of insulin resistance and lack of insulin production.

When you are prediabetic/insulin resistant, you have an elevated blood sugar and elevated insulin level. Elevated blood sugar over time can cause inflammation and damage to your organs. Elevated insulin can lead to inflammation and fat storage. This can make it more difficult to lose weight.

 

So what can you do to help improve insulin sensitivity?

The cornerstone of treating insulin resistance is diet and lifestyle!

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                     Photo by Kelly Sikkema on Unsplash

If overweight or obese, weight loss can significantly improve insulin resistance. It is not only important to look at your calorie intake, but also to know where your calories are coming from. Carbohydrates cause an increase in blood sugar, and therefore insulin, so often times we work to lower carbohydrate intake, especially those that are processed. Processed carbohydrates include white bread, white rice, low fiber cereals, etc. Protein causes less of a blood sugar elevation and fat causes no blood sugar or insulin response. Having a balance of healthy carbohydrates, fat, and protein can be key to losing weight and treating insulin resistance. In certain cases, ketosis and intermittent fasting can be used as a helpful tool as they dramatically lower blood sugar and insulin response.

Medication can be helpful as well. Metformin is the most common medication used in prediabetes. This makes your cells more sensitive to the insulin produced, thus decreasing the overall amount of insulin required.

Often overlooked aspects of treatment include stress management and sleep. Stress can lead to an increase in cortisol, your “fight or flight” hormone. This can lead to weight gain and insulin resistance. Studies have shown that lack of sleep can lead to an increase in hunger hormones and weight gain. We often tend to reach for more processed carbohydrates for quick energy when we are tired as well. Aim for 7-8 hours of uninterrupted sleep!

 

Overall, the approach to improve insulin resistance is multifactorial and should be tailored to the individual. Contact us to help you come up with a plan!