It has been estimated that 366 million people worldwide have been diagnosed with diabetes, and that one person dies of diabetes every seven seconds! These numbers are absolutely staggering, especially for a condition that is preventable and even reversible with proper diet and exercise. The bad news is that these numbers are still climbing with obesity rates rising every year, and even childhood obesity on the rise.
What is insulin resistance?
Insulin is the hormone that is released from the pancreas in response to glucose (sugar) in the blood. Insulin levels spike after eating a meal.
When insulin is released in a non-insulin resistant (healthy) person, it triggers the body’s cells to utilize glucose and fats from the bloodstream.
Insulin resistance occurs, when cells do not respond or respond weakly to the insulin signal. This results in the body secreting even more insulin and eventually creating toxic levels of glucose in the blood, known as high blood sugar.
Why is it important to recognize insulin resistance?
It’s important to recognize and diagnose insulin resistance, because it is a clear marker of a diabetic tendency, and is usually evident 10 to 15 years before true diabetes is diagnosed.
That this means is that, if testing for insulin resistance began as part of a standard physical examination, we could catch people who are at high risk of developing diabetes at a stage where it is reversible. This is truly proactive and preventative medicine.
Common symptoms of insulin resistance are:
- weight gain (often rapid in a period of two to three years)
- intense cravings for carbohydrates or sweets
- increased appetite
- feeling tired or bloated after eating
- carrying extra weight in the central abdomen
- very slow and difficult weight loss
- in women it is also associated with acne and hair thinning
Perils of insulin resistance
Insulin resistance can have some serious health consequences. Damage can happen from high blood sugar levels even before true diabetes has developed.
One of the first signs of insulin resistance is weight gain, and especially carrying weight around the central abdomen. Insulin resistance and weight gain have been shown to increase the risk of developing cardiovascular disease (i.e. atherosclerosis [hardening of the arteries], heart attack, stroke, and high blood pressure).
Insulin resistance is also associated with fatty liver disease, a condition that is often mistakenly treated by recommending a low-fat diet. The key here is to lose weight and reverse insulin resistance.
And finally, insulin resistance is associated with increased risk of developing cancers, including breast, prostate, and pancreatic cancer.
We have a disease mechanism that feeds chronic disease – it is imperative that we diagnose and treat it early. The earlier it is found, the more thoroughly it can be reversed.
Complete the following checklist to determine if you are at risk of being insulin resistant or developing diabetes.
- Are you overweight or do you have a difficult time losing weight?
- Do you carry weight around your central abdomen?
- Do you frequently crave carbohydrates and sweets?
- Were you overweight as a child?
- Did you have gestational diabetes during pregnancy?
- Do you have polycystic ovarian syndrome, or suspect that you might (i.e. have irregular periods, carry weight around the middle, and have acne)?
- Do you feel bloated and sleepy after a high-carbohydrate meal?
- Do you have thinning hair (not explained by low iron or low thyroid function), skin tags, adult acne or fatty liver?
If you check “Yes” to any of the questions above, testing for insulin resistance is highly recommended. Regular testing and preventative measures are recommended.
Testing for Insulin resistance:
There are several ways to test for insulin resistance, and I’ll list them in order from the simplest to the most in-depth:
- Fasting insulin level: this is the simplest and cheapest test, and will show cases of moderate or severe insulin resistance. Optimal levels for fasting insulin are < 50 pmol/L. This simple test may however miss milder cases.
- HOMA-IR: this is a mathematical calculation using blood levels of fasting insulin and fasting glucose. Once your numbers are put into the calculator, it is very easy to interpret: Optimal HOMA-IR is 1.5 or less; early insulin resistance HOMA-IR > 2; significant insulin resistance HOMA-IR > 3. It is still very inexpensive, but requires an extra step with an online calculator. Here are a couple of versions: http://www.thebloodcode.com/homa-ir-calculator/ and http://www.dtu.ox.ac.uk/homacalculator/index.php
- Insulin glucose challenge: The gold standard is a four-hour test called the insulin glucose challenge, and it involves visiting a standard blood lab first thing in the morning after 12 hours of fasting. A baseline fasting blood sugar and insulin level is measured first. Then, you are given a drink containing 75 grams of sugar, and blood is taken after one hour, two hours, and four hours to see how your blood sugar and insulin levels respond. Results from this test show: 1. high insulin response one or two hours after sugar ingestion if you have insulin resistance 2. high glucose response one or two hours after sugar ingestion, if you have impaired glucose tolerance.
Take charge! Insulin resistance is reversible.
Early detection of insulin resistance is important, so it does not progress to diabetes. Insulin resistance and non-insulin dependent (Type 2) diabetes are preventable and reversible with a commitment to nutrition, exercise, and stress management.
Follow the NESST approach to reversing insulin resistance:
- Nutrition—Enjoy a diet that is low in sugar and simple carbohydrates (e.g. bread, white rice, pasta, pastries, and cereals), and high in vegetables, proteins, anti-inflammatory fats, and fibre.
- Exercise—Exercise (especially cardiovascular exercise) has the ability to improve your body’s response to carbohydrates and insulin. In cases of insulin resistance, exercising at least 150 minutes per week is recommended.
- Stress reduction—Address stress, because high cortisol levels impact insulin response to carbohydrates and make it much harder to reverse insulin resistance or impaired glucose tolerance.
- Sleep—Sleep for at least seven to eight hours per night! This is essential to reverse insulin resistance. Studies have found that sleeping fewer than six hours per night puts your body in a state of insulin resistance. Adequate sleep is required for optimal weight and blood sugar response.
- Testing and treatment—Continue to check your blood sugar and insulin levels, as well as your waist circumference.
I hope this brief article has taught you about the power of preventative medicine, and that you can find signs of blood sugar disorders long before diabetes is diagnosed. Let’s push for more testing of insulin levels instead of waiting until diabetes presents.
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