Understanding what this condition does to your body – and how you can treat it

Insulin resistance often operates in ‘stealth mode’ and then goes undiagnosed – in other words, you could be insulin resistant and just not know it...

Quick biology lesson: the body’s main source of fuel is glucose, also known as blood sugar. We get glucose from the carbohydrates contained in grains, fruit, vegetables and dairy products. Our livers are also able to make the glucose our bodies need, from glycogen stored in the liver. This process occurs when we’re in a fasted state – for example, when we sleep or skip meals.

Insulin is a hormone that helps your body to remove glucose (sugar) from the blood and use it for the production of energy in the cells. Put more simply, insulin is like the chaperone that ‘knocks on the doors’ of muscle and fat cells. The cells hear the knock, open up, and insulin ushers the glucose in.

With insulin resistance, the cells stop being able to ‘hear’ the knock – so they either open the door just a little, or not at all. The glucose is left waiting outside in the bloodstream, and starts to accumulate with each morsel of food consumed. Your cells think they are starving (because glucose isn’t getting in) and send a signal to the brain to eat more carbs and/or sugary food. At this point, you can start experiencing sugar cravings that become very difficult to control, and a vicious cycle begins. Blood glucose levels then begin to rise to abnormal levels, which is highly toxic to the body. The pancreas gets the red alert and starts to pump out more and more insulin to make the ‘knock’ even louder.

This works for a while, with the pancreas doing an effective job of pumping out enough insulin to keep glucose levels within the normal range. This is the ‘stealth mode’ we mentioned earlier. The only sign at this stage that there is trouble coming your way is higher-than-normal insulin levels. Unfortunately, the problem is often not detected at this early stage, as checking insulin levels is not a blood test that doctors routinely perform.

This is a great pity as elevated insulin levels in the blood are highly inflammatory, disrupting hormones and damaging the body. It is also the first sign that you could be insulin resistant. Knowing that your insulin is too high would allow you to take action much sooner.

So what happens next in the insulin resistance process? All the extra work of pumping out loads of insulin to control blood sugar tires out the pancreas. It stops being able to cope with the workload. Production of insulin drops off – and now there isn’t enough to combat the high levels of blood sugar and keep it in check. This is when blood sugar levels start to rise unabated. Very often, insulin resistance, or diabetes, is only picked up at this stage by the doctor, because testing glucose is reasonably routine as part of an annual check-up. High blood sugar levels cause even more inflammation in the body and damage to cells, and ultimately lead to type 2 diabetes as well as increasing the risk for cardiovascular disease, stroke and cancer. It is also not uncommon for type 2 diabetes sufferers to have to undergo limb amputations.

To sum up: insulin resistance is the pre-cursor to type 2 diabetes, a chronic condition that necessitates ongoing medication to control blood sugar levels and, in many cases, the regular injection of insulin to substitute for a pancreas that now functions incorrectly.

WHAT CAUSES IT?

According to Dr Jason Fung, author of The Obesity Code, it is consistently high insulin levels that cause insulin resistance. Some people are more predisposed than others to acquiring insulin resistance. There are factors such as ethnicity, genetics and advancing age – over which we have no control, that put some people at higher risk.

Then we have the factors that we are able to do something about, and they all relate to lifestyle choices. Did you know that a high-carb diet, insufficient sleep, extra body weight (especially around the belly), smoking and lack of exercise could all be contributing towards the

problem of excess insulin?

SYMPTOMS

While comprehensive blood testing of insulin and glucose is what leads to a proper diagnosis of insulin resistance, there are some other telltale signs to look out for. Being aware of these signs could be what prompts you to request the proper blood tests from your doctor.

THEY ARE AS FOLLOWS:

• A waist circumference of more than 80cm for women and 94cm for men. • High blood pressure • Skin tags (small fleshy growths – often on the neck or armpits) • Patches of darkened skin on the back of the neck or on the elbows, knees, knuckles or armpits. • High triglycerides and low HDL cholesterol (requires blood tests) • Feeling tired and lethargic • Hunger and cravings • Poor concentration • Difficulty losing weight and

easy weight gain • Other associated factors are polycystic ovarian syndrome (PCOS) and a history of gestational diabetes

TREATMENT

You can go the medical route, with advice from your GP. Some doctors will prescribe a medication called Glucophage (Metformin). It works by decreasing glucose production by the liver and increasing the insulin sensitivity of cells. While Metformin can lower blood glucose, it doesn’t get to the root of the problem. And it isn’t without side effects.

The best approach for treating insulin resistance lies in making lifestyle changes.

Supplementation

A natural supplement called Berberine has been shown to be just as effective as Metformin for lowering blood sugar. It also assists with weight loss and helps improve cardiovascular health along with a variety of other health benefits.

Nutrition

Losing excess weight will improve insulin sensitivity (reduce insulin resistance). So any eating plan that facilitates weight loss will help. But for the best results, experts recommend a low-carb approach. Cutting back on sugar and starch means less glucose in the bloodstream and, as a result, a reduced need for insulin.

Conversely, a diet high in carbs will aggravate the situation by raising blood sugar, leading to a higher production of insulin and, very often, more weight gain.

Intermittent fasting

Results from intermittent fasting and restricted feeding studies look promising. Intermittent fasting can be done a number of ways, so doing your own research is advised. The easiest way to start is by cutting out all snacks between meals. You may then decide to go from three meals a day down to two a day, a few times a week. Another simple approach is to stop eating by 7pm and only eat again from 11am the next day.

For some people, a 24-hour fast once or twice a week works well. If there is no food coming in, blood sugar and insulin stay low. This provides the cells an opportunity to recover and become more insulin sensitive.

Exercise

The more active you are, the more blood sugar your muscles take out of the bloodstream and burn for fuel. This lowers the need for insulin. Studies suggest that high-intensity interval training (HIIT), resistance training, and cardio training help to improve insulin sensitivity. Being sedentary worsens insulin resistance.

Sleep

Sleep is vital for healthy blood sugar and insulin regulation. Studies show that short-term sleep deprivation and chronic sleep issues like sleep apnoea raise blood sugar levels and worsen insulin resistance. Aim for seven to eight hours of sleep each night.

Other lifestyle factors contributing to treating insulin resistance are stress reduction and quitting smoking. While great strides can be made in reducing insulin resistance using the above lifestyle changes, they need to be maintained over the long term to be effective. The moment you go back to eating too many carbs or sugary foods, not exercising regularly or smoking, you’ll be back at square one.