Do you often feel tired?

How about hungry all the time?

Cravings a little out of control?

Brain fog becoming an issue at work?

Read on to find out why you might be experiencing these symptoms and what to do about it.

Insulin resistance is a condition that, over time, has the potential of becoming a very serious health issue. It is the pre-cursor to type 2 diabetes ,which is 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 no longer functions correctly.  It is also not uncommon for type 2 diabetics to have to undergo limb amputations. Despite the long term consequences of untreated insulin resistance, it often goes undiagnosed due to the “stealth mode” under which it operates.

In other words, you could be insulin resistant and just not know it.

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, from glycogen stored in the liver, to make the glucose our bodies need. This process occurs when 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 that well, so either don’t open their doors very wide 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 carbohydrates 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” mentioned earlier. The only sign, at this stage, that there is trouble coming one’s way, is higher than normal insulin levels. Unfortunately, the problem is often not detected at this early stage as checking insulin levels is not always a routine blood test that doctors perform. This is a great pity as elevated insulin levels in the blood is highly inflammatory, disrupts hormones and is damaging to 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 work load. 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 starts 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 annual check-ups. High blood sugar levels cause even more inflammation in the body and damage to cells and ultimately leads to type 2 diabetes as well as increasing the risk for cardiovascular disease, stroke and cancer.

What causes it?

According to Dr Jason Fung, author of The Obesity Code, it is consistently high insulin levels that causes insulin resistance. Some people are more predisposed than others to acquiring insulin resistance. There are factors like ethnicity, genetics and advancing age – over which one has no control, that play a role at putting some people at higher risk than others. 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 in 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 tell-tale signs to look out for. Being aware of these signs could be what prompts you to request the proper blood tests from your doctor earlier than might otherwise have been the case.

They are as follows:

• A waist circumference of more than 80 cm for women and 94 cm 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 for insulin resistance?

You have the option of the medical route. Your GP can advise you regarding the options.  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. Also, just like with any other drug it isn’t without side effects either.

The best approach for treating insulin resistance lies in 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 amongst a variety of other health benefits .

Nutrition

Just losing excess weight will improve insulin sensitivity ,i.e., reduce insulin resistance. So any eating plan that facilitates weight loss will help. For the best results however, the experts recommend a low carb diet.  Cutting back on sugar and starch means less glucose in the blood stream 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 with regards to combatting insulin resistance.  Intermittent fasting can be done a number of ways so doing your own research is advised. The easiest way to start the practice of restricted feeding is by cutting out all snacks between meals.  You may then decide to go from 3 meals a day down to 2 a day, a few times a week. Another simple approach is to stop eating by 7pm and then only begin eating 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 with the opportunity to recover and become more insulin sensitive.

Exercise

The more you move and are physically active, the more blood sugar your muscles take out of the blood stream and burn for fuel. This lowers the need for insulin. Studies suggest that high-intensity interval training (HIIT), resistance training, and cardio training all help to improve insulin sensitivity. On the flip side, being sedentary can worsen insulin resistance.

Sleep

Getting enough sleep is very important 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 worsens insulin resistance. Try and get a solid 7 to 8 hours of sleep each night.

Other lifestyle factors that contribute towards treating insulin resistance is stress reduction and quitting smoking.

What is important to note is that while great strides can be made in reducing insulin resistance using the above lifestyle changes, they need to be maintained over the long term in order to be effective. The moment one goes back to eating too many carbs or sugary foods, not exercising regularly or picking up a smoking habit again, one could be back at square one.

“Studies estimate that up to 45% of the US population and similar numbers in other countries currently have insulin resistance. In studies of obese women, more than 70% are insulin resistant.”- Diet Doctor

Interesting fact:

When insulin levels are high, it stimulates fat cells to take up glucose from the blood and turn it into fat. Then, when insulin is low, it enables the body to take the fat out of storage and use it for energy. The taker home message? Keep insulin levels low if your goal is fat loss.

Article written by Nicky Perks for Lose It magazine. Volume 34.

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