Insulin resistance is becoming a problem on a global scale and no age group is left untouched. I am seeing young students in their teens with insulin resistance on a weekly basis. Many people do not fully understand what insulin resistance is and how it can be prevented. I hope this explanation helps.
What is Insulin?
Glucose in your blood serves as fuel for the cells in your body, but your cells need insulin to allow them to extract the glucose from your blood and take it inside the cells. So insulin can be seen as a key – it opens the door of the cells so that glucose can get into the cells and be used. This is important for 2 reasons:
- Your cells need the glucose. Without any insulin to allow glucose inside, the cells get starved. This can actually lead to a medical emergency called diabetic ketoacidosis which is potentially life-threatening.
- Without insulin, the cells can’t use the glucose, so the glucose in the bloodstream keeps accumulating. High blood glucose levels can lead to all sorts of problems including eye damage, kidney damage, heart disease, strokes, seizures/fits, coma and death.
So from this you can see how important it is that our bodies have insulin and that the insulin works properly. In diabetes melitis (sugar diabetes), the patient has an abnormally high sugar level most of the time due to either a lack of insulin (their body can’t make the amount of insulin they need) or because their insulin just doesn’t work well enough – even though they have more than enough of it.
When Insulin Doesn’t Work Properly…
Insulin resistance is not the same as diabetes. As I said before, in diabetes, the blood sugar level is elevated most of the time because insulin isn’t doing its job. With insulin resistance, your insulin is not working as well as it should, but your sugar level is still within the normal range or only slightly increased (not increased as high as in diabetes). In this condition, your body is struggling to keep your sugar levels at a normal level. In fact, your body is often making an excessive amount of insulin to try to keep your sugar levels as normal as possible. Basically, your body is desensitised to the insulin so that more and more is needed to keep your sugar levels under control. Eventually, your body simply can’t make enough insulin to keep your sugar levels normal and that is when your blood sugar level starts to creep up. With time your body tires out from having to make so much insulin and eventually your body just can’t keep it up anymore and you start to make less and less insulin. Your sugar levels start to get even higher and you develop proper diabetes.
Why Does the Insulin not Work Properly?
There are many different reasons why your insulin may stop working properly and many more are being discovered by further research. These are just some of the reasons:
- Diet A diet consisting of lots of high GI foods (which cause recurrent insulin spikes), bad fats and little fibre can be a cause. High GI foods refer to foods like sweets, chocolates, cakes, sugared cooldrinks etc which cause a sudden release of lots of glucose into your bloodstream. The sudden glucose spike in your bloodstream makes your body release a burst of insulin to try to open the doors of the cells and let the glucose into the cells so that the blood glucose level can drop back to normal. If your diet consists largely of these high GI foods, your body is constantly sending out bursts of insulin. This means that the little insulin receptors on your cells get bombarded with high levels of insulin constantly. Using the analogy of the door and key: The key (insulin) gets shoved into the keyhole of the door (the glucose entry point of the cell) repeatedly and forcefully, to the point that eventually, such damage is done to the keyhole that the key doesn’t fit nicely into the keyhole anymore and the key therefore struggles to open the door. So eventually, the cells just don’t respond like normal to the insulin. This means that the blood glucose level stays higher for longer because the glucose isn’t being used, so the body tries to make more insulin in an attempt to get it into the cells. So the receptors get bombarded even more, making them even less sensitive…You get the picture.
- Central Obesity Fat cells are not supposed to be making hormones. They’re just supposed to sit there and keep you padded and warm. However, if abdominal/tummy fat cells become very full of fat and enlarged, they actually become little hormone factories that make nasty hormones like cortisol that work against your insulin and make your insulin less effective. Note that it is not the fact that you have fat cells over your tummy that causes this – we all have fat cells over our tummy – even skinny people. It is only when these cells become over full – stuffed to the brim with fat – that this happens.
- Exercise Regular exercise sensitises your insulin receptors to your insulin and thus helps prevent insulin resistance.
- Genetics Unfortunately, the tendency to get desensitised to your body’s insulin is genetically transferred. This, however, does not mean that if you have diabetes in your family that you will become a diabetic! By living a healthy lifestyle, most people who have an inherited tendency towards insulin resistance can avoid both insulin resistance and eventual diabetes.
- Medication Certain medication (such as some blood pressure medications) can increase your tendency to become insulin resistant. An unhealthy lifestyle, a genetic predisposition AND this type of medication, could lead to insulin resistance and eventually diabetes.
- Pregnancy Some of the pregnancy hormones make your body’s insulin less effective and therefore some women become diabetic during pregnancy but once the baby is born, the diabetes goes away. These women are usually insulin resistant even before the pregnancy, but their body is able to make enough insulin to still keep the sugar levels in the normal range. Any woman who develops diabetes in pregnancy, is therefore at high risk of developing diabetes later in life again.
- Metabolic Syndrome This refers to a cluster of conditions that tend to develop together in a single patient. These are obesity (especially central/tummy obesity), diabetes, dyslipidaemia (a bad cholesterol and blood fat profile), too much uric acid in the blood which often leads to gout, polycystic ovaries in women and a condition called fatty liver. This set of conditions increases your risk of all sorts of problems like heart disease, strokes etc.
How to Check if You Have Insulin Resistance
Visit your doctor once a year for a full medical examination. Your doctor can look for signs on examination that can indicate the development of insulin resistance. Some of these signs include an increased BMI, acanthosis nigricans (a dark velvety change to the skin behind your neck), skin tags in the neck (fleshy growths in the neck), hirsutism (increased hairiness in females) etc. Your doctor can also do some blood tests. You must be fasted before doing these blood tests (nil per mouth from 10pm the night before and then take the bloods the following morning before breakfast). You need your fasting glucose level and fasting insulin level checked. Your doctor may also want to send you for a glucose tolerance test if needed. Remember that early on with insulin resistance, your glucose level will be normal. That is why a fasting insulin test is also needed. If your insulin level is very high with a normal glucose level – you are insulin resistant and are likely to develop diabetes in the future if you do not take corrective measures.
The Good News
Research shows that diabetes due to insulin resistance (also known as Type 2 diabetes) can be turned around. Dr Neal Barnard and others of the Physicians Committee for Responsible Medicine have done research on the influence of a low-fat, entirely plant-based diet on diabetes. The results were astounding. Many patients that were on diabetic medication for years were able to either significantly reduce the amount of medication needed per day in order to control their glucose level or they were able to completely reverse their diabetes and get off medication completely!
The rules for this new lifestyle are really simple:
- avoid all animal products – no meat, fish, eggs, dairy or any other product that is derived from animals
- minimise fats and oils
- avoid high GI foods as much as possible
No calorie counting, no diet sheet telling you what to eat at every meal – just 3 simple and easy to follow rules. With this lifestyle, you will not only reverse/significantly improve insulin resistance and diabetes, but you will feel light and energised, lose weight until you reach a healthy weight for your body, improve blood pressure control, significantly reduce a bad cholesterol profile and perhaps add some extra years to your life.
For more information on this lifestyle, read this book by Dr Neal Barnard. Here are the personal stories of some individuals who have seen this lifestyle make an impact on diabetes first hand: