Beware of insulin resistance
You’ve probably heard of the terms ‘‘pre-diabetes’’ and ‘‘insulin resistance’’, but given no thought as to how they could relate to you.
Insulin is a hormone produced in the pancreas, and plays a major role in your metabolism. It assists cells in absorbing glucose into the body to use for energy.
When the body becomes insulin resistant, it struggles to absorb glucose from the bloodstream and leads to high blood sugar. Left unchecked, you’re at risk of prediabetes – the condition whereby blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes – which will often actually develop into Type 2 diabetes.
Few people know they have any kind of insulin resistance and most go undiagnosed because it has no symptoms. The Journal of Diabetes Complications has estimated that 32.2 per cent of people have insulin resistance, while the journal Minerva Endocrinologica found that more than 70 per cent of overweight and obese women will be affected.
Often people only find out about glucose absorption problems when it’s too late when a Type 2 diabetes diagnosis has been given.
Genetic factors are significant in insulin resistance, but lifestyle choices play a large part too. Elevated free fatty acids in the body stop it responding properly to insulin by disrupting the pathways needed, and this is caused by excess calorie consumption and the carrying of too much body fat.
Scientifically, overeating, weight gain and obesity are strongly correlated to insulin resistance, particularly when belly fat is present. Having a waist measuring more than 100cm for men and 88cm for women puts you at risk.
However, people at a healthy weight can also become insulin resistant.
The journals Nutrition & Metabolism and Journal of Nutrition have linked high fructose consumption from added sugars to insulin resistance.
Oxidative stress and increased inflammation in the body may lead to resistance as well, according to Oxidative Medicine and Cellular Longevity and Diabetes journals, while the International Journal of Behavioral Nutrition and Physical Activity has found that persistent physical inactivity also relates.
Insulin resistance and prediabetes can be tested for by several kinds of blood tests, including the AC1 test, the fasting plasma glucose (FPG) test, and the oral glucose tolerance test (OGTT).
If you find out you have become insulin resistant or pre-diabetic this can be reversed, or significantly reduced, and Type 2 diabetes may not develop.
According to new research by the University of Arkansas, physical activity offers the ‘‘greatest protection’’ against insulin resistance, and even light exercise – example 30 minutes a day, five times a week – carries the benefits.
You should aim to lose the deep visceral fat from your stomach (what you know as belly fat or a ‘‘spare tire’’).
Abdominal fat cells can disrupt the functioning of hormones leptin and adiponectin, according to Harvard University Medical School, which are thought to affect your response to insulin.
With visceral fat directly linking to insulin resistance, ‘‘central obesity’’ (a fat concentration around the middle) is the only physical indicator that you could be in danger.
In combination with exercise, a dietary overhaul should take place. Cutting out all refined carbohydrates (like biscuits and crackers, breakfast cereals, white bread) and anything containing added sugar is key. Your body is unable to metabolise these items and they quickly convert into sugar in your body.
It’s also thought that increasing the quality and quantity of your sleep can prevent insulin resistance. Just a single night of sleep deprivation may induce the metabolic pathways of insulin resistance, according to the Journal of Clinical Endocrinology and Metabolism, so it’s easy to see how long-term poor sleep can be problematic.
Though limited, there’s some evidence that chronic stress and depression are independent risk factors for insulin resistance, according to the Journal of Endocrinology, and it pays to be aware that interventions in these areas can help not just your mind, but your body, too.
The most important takeaway here is this: don’t wait for a diabetes diagnosis before you take action. Insulin resistance is a serious matter and there’s a lot in your control to prevent or reduce it. ❚ Lee Suckling has a masters degree specialising in personal health reporting. Do you have a health topic you’d like Lee to investigate? Send us an email to life.style@fairfaxmedia.co.nz with Dear Lee in the subject line.
Q: My daughter has just been diagnosed with an ovarian cyst. Can you tell me a little bit more about these types of cysts, and what treatment she might have to have? Many thanks, Kathryn.
A:Ovarian cysts are really common, and there are several types. Obviously without knowing more detail about your daughter’s condition it is hard to give you specific advice – but here are some facts about ovarian cysts in general, and what can be done to manage them.
The two ovaries sit on either side of the womb, and are roughly the size of a walnut. Their role is to make eggs, then release them into the fallopian tubes so they can be fertilised and implant in the womb. In menstruating women, an egg is produced each cycle – the egg matures inside a small structure called a follicle. Once the egg is released, the follicle turns into a ‘‘corpus luteum’’, which produces hormones to support a pregnancy should the egg go on to be fertilised. If you don’t become pregnant that cycle, the corpus luteum gradually shrinks away, and the cycle begins again.
Cysts are simply fluid-filled sacs, and can occur almost anywhere within the body. When they occur on or in an ovary, they are known as ovarian cysts. Most ovarian cysts are not dangerous and, in fact, many will cause no symptoms at all and simply be detected incidentally during tests such as ultrasound scans. However, some do cause symptoms, and need to be removed. Ovarian cysts can vary hugely in size – some merely the size of a pea, while others can grow bigger than large melons. Very rarely, certain types of cyst can become cancerous, but this is definitely the exception. The most common types include:
Functional cysts – these can form as part of the normal ovulation cycle. They are termed ‘‘follicular’’ cysts that occur when a developing follicle enlarges and fills with fluid, or ‘‘corpus luteal’’ cysts, when a corpus luteum gets filled with fluid or blood. They can grow to about 6 centimetres across, and will cause pain for some women, but usually they go away on their own after a few months, and don’t need anything done about them.
Dermoid cysts – these unusual
Genetic factors are significant in insulin resistance, but lifestyle choices play a large part too.