What is Insulin Resistance?

Insulin is a hormone produced by our pancreas that helps sugar (i.e. glucose) enter our cells. It has a major impact on our metabolism and how our body gets energy. When our muscle, brain and tissue cells stop responding to insulin this causes a condition called insulin resistance. If our cells become resistant to insulin then our pancreas needs to create even more insulin to get the glucose inside those stubborn cells. This can become a slippery slope as the cells become more and more resistant and the pancreas keeps cranking out more and more insulin. Over time our poor pancreas becomes exhausted and then we can be diagnosed with type 2 diabetes. Type 2 diabetes is when the pancreas is damaged and can’t meet the body’s insulin demands.

There is good news. You can find out if you have insulin resistance and, if managed well, it can be reversed. First let’s note some of the top causes that lead to insulin resistance:

  • A diet high in calories and trans fats. Overeating is highly correlated with insulin resistance[i].
  • Obesity, especially if weight is held in the abdominal area (i.e. visceral fat)[ii].
  • Chronic inflammation.
  • High amounts of high fructose corn syrup in diet[iii].
  • Physical inactivity[iv].
  • Unhealthy bacteria living in your gut[v].
  • Chronically high stress levels.

There are many other factors that can lead to insulin resistance. We know that ethnic background, family history, age and smoking history also play a role. It may not be surprising then that the best treatment for insulin resistance is lifestyle medicine. This is where naturopathic medicine really shines. Helping people eat more balanced meals, incorporate more movement into their lives, manage stress better and lower inflammation can reverse insulin resistance. Weight loss will happen naturally but the primary focus of treatment should be living healthier and feeling better- we consider losing pounds a nice side effect and not the over-arching goal.

So how do you know if you are insulin resistant?  Although there isn’t one single test that confirms insulin resistance, having some thorough blood work can be very helpful. I recommend patients have the following tested if we are concerned about insulin resistance:

  • Fasting glucose
  • Fasting insulin
  • Cholesterol Panel (including triglycerides, LDL, HDL, Total Cholesterol)
  • HbA1C
  • hsCRP

These are considered standard tests and are available through your naturopathic doctor or medical doctor. After receiving these results, I usually use the HOMA calculator (available online) to get a calculated value for insulin resistance. This is a helpful measurement to use every 6 months with patients to monitor progress and success at reversing insulin resistance.

Understanding how your insulin is working in your body is a wonderful opportunity to practice pro-active medicine. It is the chance to really turn things around and avoid future chronic diseases. I tell my patients to see insulin resistance as a warning sign from our body that, if listened to, can result in profound improvements in health and enjoyment of life.

 

[i]Tam CS et al Short-term overfeeding may induce peripheral insulin resistance without altering subcutaneous adipose tissue macrophages in humans. Diabetes. 2010 Sep;59(9):2164-70.

[ii] Bergman, R. N., Kim, S. P., Catalano, K. J., Hsu, I. R., Chiu, J. D., Kabir, M., Hucking, K. and Ader, M. (2006), Why Visceral Fat is Bad: Mechanisms of the Metabolic Syndrome. Obesity, 14: 16S–19S. doi:10.1038/oby.2006.277

[iii]  Basciano, H et al.  Fructose, insulin resistance, and metabolic dyslipidemia. Nutrition & Metabolism (2005). 52.

[iv] Park YW. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994.  Arch Intern Med. 2003 Feb 24;163(4):427-36.

[v] Caricilli AM, Saad MJA. The Role of Gut Microbiota on Insulin Resistance. Nutrients. 2013;5(3):829-851.