Insulin Resistance: What Is It and How To Treat It Naturally
In the scope of metabolic health, insulin resistance is a critical syndrome that affects millions worldwide. It's a condition that not only impacts your body's ability to manage blood sugar levels but also has larger implications for your overall health. This post explains insulin resistance, helping you understand what it is, how to recognize it, and the steps you can take to address it.
Insulin Resistance Is a Metabolic Condition
Insulin resistance is a metabolic condition where the body's cells become less responsive to insulin, a hormone produced by the pancreas. Insulin allows sugar (glucose) in the bloodstream to enter the cells. This sugar then provides the cells with the energy they need to function. When cells resist insulin's action, blood sugar levels rise, prompting the pancreas to produce even more insulin. This leads to a vicious cycle that can have serious health consequences.
Beta cells in the pancreas secrete insulin in response to sugars in the blood. The insulin is detected by cells, and a pathway opens up to let the sugar into the cell to be used as energy.
With insulin resistance, the insulin is no longer signaling to the cell to open the pathway that lets sugar in. This leads to a build-up of BOTH sugar and insulin in the bloodstream.
Common Signs and Symptoms of Insulin Resistance
Identifying insulin resistance early can be challenging, as it often develops silently and gradually. However, certain signs and symptoms may indicate its presence:
Elevated fasting blood sugar levels
Fatigue, especially after meals
Intense cravings for carbs or sweets
Increased waist circumference
High blood pressure
Dark, velvety patches of skin, particularly around the neck and armpits (a condition known as acanthosis nigricans)
Polycystic ovary syndrome (PCOS) in women
How Do I Know I Am Insulin Resistant?
Recognizing insulin resistance involves observing the signs and symptoms mentioned above. However, the most accurate way to diagnose insulin resistance is through medical tests. Your healthcare provider may use various tests, such as fasting insulin and glucose levels, lipid panels, and oral glucose tolerance tests to evaluate your insulin sensitivity.
The Main Cause of Insulin Resistance
The exact cause of insulin resistance is complex and multifactorial, involving a combination of genetic, lifestyle, and environmental factors. Key contributors include:
Excess body weight, particularly around the abdomen
A diet high in processed foods and sugars
Chronic inflammation
Hormonal imbalances
Physical inactivity
Genetic predisposition
Understanding Insulin Resistance, Prediabetes, and Type 2 Diabetes
Navigating through the terms insulin resistance, prediabetes, and type 2 diabetes can be confusing. Let's break down these concepts to enhance your understanding and highlight the importance of early intervention.
Insulin Resistance: The Starting Point
Insulin resistance is a condition where the body's cells don't respond effectively to insulin, a hormone that helps regulate blood sugar levels. This inefficiency can lead to increased blood sugar and insulin levels. While it's a key factor in developing type 2 diabetes, not everyone with insulin resistance will progress to this stage, especially when lifestyle changes and interventions are started early.
Insulin Resistance vs Prediabetes
Prediabetes is the middle ground where blood sugar levels are higher than normal but not yet high enough for a type 2 diabetes diagnosis. It tells us that glucose management in the body is starting to falter, mainly due to insulin resistance. Prediabetes is a critical warning sign, indicating that without intervention, type 2 diabetes is more likely to develop. The prevalence of prediabetes is increasing worldwide and experts have projected that more than 470 million people will have prediabetes by 2030 (4).
Most individuals with prediabetes have already been experiencing insulin resistance for quite some time. Recognizing and addressing insulin resistance and prediabetes early can significantly reduce the risk of progressing to type 2 diabetes.
Insulin Resistance vs Type 2 Diabetes
Type 2 diabetes develops when insulin resistance becomes severe, and the pancreas can't produce enough insulin to maintain healthy blood sugar levels. Studies indicate that about 30-40% of individuals with insulin resistance may develop type 2 diabetes within 12 years (2). Understanding this progression is crucial for early prevention strategies.
The Importance of Early Treatment for Insulin Resistance
Recent research has shed new light on the development of insulin resistance and its progression to prediabetes, challenging previous understandings of how the disease affects the body. It's now known that the decline in beta cell function (cells in the pancreas that make insulin) and the worsening of insulin resistance occur at the same time, rather than one after the other. This simultaneous change underscores the need for early intervention. Once the beta cells are damaged, they are set on a trajectory to cell death if nothing is done.
Even in cases where individuals manage to keep their blood sugar levels within a normal range, possibly due to obesity or other factors, there's still a noticeable decrease in the efficiency of beta cells. This means that the body's ability to produce and respond to insulin is compromised, leading to a cycle of worsening insulin resistance and beta cell strain.
Research is showing that beta-cell damage in the pancreas (previously thought only to occur in diabetes) occurs at earlier “insulin-resistant” stages. This is prompting researchers to recommend early intervention measures to prevent further damage to the pancreas and preserve its ability to produce insulin. (Esser, 2020)
How Insulin Resistance Affects the Entire Body
In The Liver: In the liver, insulin resistance disrupts the normal process that regulates sugar production. Normally, insulin tells the liver to slow down or stop releasing sugar into the blood when it's not needed. Insulin resistance disrupts this feedback loop, leading to excessive sugar in the bloodstream even when it's not required.
In The Brain: The evidence suggests that insulin resistance has a profound impact on the brain, contributing to cognitive dysfunction, neurodegeneration, and the pathology of conditions such as Alzheimer's disease (9).
In Muscle Cells: Muscle cells play a vital role in removing glucose from the blood, using it for energy. Insulin resistance makes muscle cells less efficient at this task, contributing to higher overall blood sugar levels.
In The Kidneys: Insulin resistance affects various aspects of kidney function and contributes to the development of kidney stones, hypertension, and impaired glucose metabolism.
In The Heart: Insulin resistance plays a major role in the development and progression of cardiovascular diseases and cardiovascular health, including vascular dysfunction, ischemic heart disease, increased stroke risk, and inflammatory processes (5).
In Fat Cells: Insulin resistance significantly affects adipose tissue and can impede weight loss efforts. It contributes to something called adipose tissue dysfunction, where insulin resistance leads to a cycle of inflammation in the fat tissue, that further fuels and worsens the condition.
In the Ovaries: An excess of insulin in the fluid of cells surrounding the ovaries can disrupt normal hormone levels, and increase the production of androgens, leading to irregular menstrual cycles and fertility issues. This mechanism is a key part of PCOS.
In The Gut: Insulin resistance affects the gut by altering the balance of bacteria, impacting digestion, and potentially contributing to inflammation and increased intestinal permeability, sometimes referred to as "leaky gut."
Key Insight: The widespread impact of insulin resistance highlights the critical need for early detection and management. Addressing insulin resistance before it progresses can help preserve beta cell function and prevent the cascade of metabolic issues that follow.
Testing for Insulin Resistance
If you suspect you might be insulin resistant, it's crucial to consult with a healthcare provider. They can recommend appropriate tests to measure your insulin and glucose levels, providing valuable insights into your metabolic health. The American Diabetes Association suggests Universal screening for all people over age 35.
Key Markers Associated with Insulin Resistance:
When it comes to assessing your risk for insulin resistance, it's important to understand that there is no single definitive test for this condition. Instead, healthcare professionals rely on a collection of associated blood markers to evaluate insulin sensitivity and metabolic health. These indicators provide valuable insights and can guide interventions accordingly. Let's explore these key markers associated with insulin resistance.
Triglycerides: Elevated triglycerides are a common consequence of insulin resistance, reflecting changes in the body's lipid metabolism. A level greater than 130 mg/dL often indicates insulin resistance.
Triglyceride to HDL Ratio: When your body becomes insulin resistant, it can lead to the breakdown of High-Density Lipoprotein (HDL), the "good" cholesterol. This can affect the balance between triglycerides and HDL in the blood and is a relatively good indicator of insulin resistance. A ratio above 2.5:1 for Caucasians 1.5:1 for African Americans suggests insulin resistance.
Fasting Insulin Levels: Fasting insulin levels exceeding 15.7 microU/mL can point to insulin resistance. However, this marker has limitations due to the variability in assay standardization, making it a less reliable indicator on its own.
HbA1c: Levels above 5.5% may indicate insulin resistance and an elevated risk of diabetes. HbA1c provides an average of blood glucose levels over the past two to three months, offering insight into long-term glucose management.
Fasting Glucose: A fasting glucose level above 106 mg/dl is a marker of insulin resistance, measuring blood glucose concentration after an overnight fast.
Oral Glucose Tolerance Test (OGTT): This test assesses blood glucose levels before and after ingesting a glucose-rich drink, evaluating the body's glucose processing efficiency. It is crucial for diagnosing insulin resistance and diabetes.
Interpreting the Results
The interpretation of these markers should be holistic, considering the collective profile rather than individual values. The presence of these elevated markers on routine bloodwork should prompt you to seek comprehensive evaluation by a healthcare professional, who will take into account your overall health, medical history, and lifestyle to understand the implications fully.
How To Manage Blood Sugar Levels and Insulin Resistance Naturally
Fortunately, insulin resistance can be improved, and in some cases, reversed through lifestyle modifications. There is an overwhelming body of research that shows that lifestyle modification is the cornerstone of treatment for individuals with insulin resistance and prediabetes, and can reduce the overall risk of disease progression by up to 70% (3).
Dietary Changes: Adopting a diet rich in whole foods, fiber, healthy fats, and lean proteins while reducing the intake of processed foods and sugars can significantly improve insulin sensitivity. There is plentiful research that demonstrates that eating a Mediterranean-style diet has beneficial effects on controlling blood sugar and reversing insulin resistance. Focus on eating balanced meals containing fat, protein, and carbohydrates. Try to add a protein source when eating carbohydrate snacks.
Regular Exercise: Both aerobic and resistance training exercises can enhance the muscle cells' ability to use glucose and improve insulin sensitivity. It does this by increasing the amount of glucose transporters in muscle cells that act as little pathways for sugar to exit the bloodstream and enter the cells.
Weight Management: Losing excess weight, especially abdominal fat, can have a profound effect on improving insulin action (9).
Stress Management: Chronic stress has been shown to exacerbate insulin resistance, making stress-reduction techniques like meditation, yoga, or deep breathing exercises beneficial.
Adequate Sleep: Ensuring sufficient and quality sleep each night can help in regulating hormones that influence insulin sensitivity.
Insulin Resistance Key Takeaways
Insulin resistance is a silent condition with significant health implications.
It is essentially a syndrome before a syndrome (pre-diabetes/type 2 diabetes).
Recognizing the signs and understanding the risk factors are the first steps toward managing and potentially reversing this condition.
Taking preventive measures is crucial.
Addressing this condition early on can significantly change the course of your health for the better.
Research shows that lifestyle changes, improved nutrition, and sometimes strategic supplementation can improve insulin sensitivity and safeguard your metabolic health.
Are You Concerned About Insulin Resistance?
Resources:
Esser, N. and Utzschneider, K. M. (2020). Early beta cell dysfunction vs insulin hypersecretion as the primary event in the pathogenesis of dysglycaemia. Diabetologia, 63(10), 2007-2021. https://doi.org/10.1007/s00125-020-05245-x
Echouffo-Tcheugui JB, Perreault L, Ji L, Dagogo-Jack S. Diagnosis and Management of Prediabetes: A Review. JAMA. 2023 Apr 11;329(14):1206-1216. doi: 10.1001/jama.2023.4063. PMID: 37039787.
Cefalu, W. T., Buse, J. B., Tuomilehto, J., Fleming, G. A., Ferrannini, E., Gerstein, H. C., … & Kahn, S. E. (2016). Update and next steps for real-world translation of interventions for type 2 diabetes prevention: reflections from a diabetes care editors’ expert forum. Diabetes Care, 39(7), 1186-1201. https://doi.org/10.2337/dc16-0873
Tabák, Á., Herder, C., Rathmann, W., Brunner, E., & Kivimäki, M. (2012). Prediabetes: a high-risk state for diabetes development. The Lancet, 379(9833), 2279-2290. https://doi.org/10.1016/s0140-6736(12)60283-9
Brannick, B. and Dagogo‐Jack, S. (2018). Prediabetes and cardiovascular disease. Endocrinology and Metabolism Clinics of North America, 47(1), 33-50. https://doi.org/10.1016/j.ecl.2017.10.001
Christensen, A. A. and Gannon, M. (2019). The beta cell in type 2 diabetes. Current Diabetes Reports, 19(9). https://doi.org/10.1007/s11892-019-1196-4
Islam, Fahadul & Khadija, Jannatul & Islam, Md. Rezaul & Shohag, Sheikh & Mitra, Saikat & Alghamdi, Saad & Babalghith, Ahmad & Theyab, Abdulrahman & Rahman, Mohammad & Akter, Aklima & Mamun, Abdullah Al & Alhumaydhi, Fahad & Emran, Talha. (2022). Investigating Polyphenol Nanoformulations for Therapeutic Targets against Diabetes Mellitus. Evidence-based Complementary and Alternative Medicine. 2022. 1-16. 10.1155/2022/5649156.
Kahn, S. E. (2003). The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes. Diabetologia, 46(1), 3-19. https://doi.org/10.1007/s00125-002-1009-0
Klöting, N., Faßhauer, M., Dietrich, A., Kovacs, P., Schön, M., Kern, M., … & Blüher, M. (2010). Insulin-sensitive obesity. Ajp Endocrinology and Metabolism, 299(3), E506-E515. https://doi.org/10.1152/ajpendo.00586.2009
Ma, L., Wang, J., & Li, Y. (2015). Insulin resistance and cognitive dysfunction. Clinica Chimica Acta, 444, 18-23. https://doi.org/10.1016/j.cca.2015.01.027
Femminella, G., Livingston, N., Raza, S., Doef, T., Frangou, E., Love, S., … & Edison, P. (2021). Does insulin resistance influence neurodegeneration in non-diabetic alzheimer’s subjects?. Alzheimer S Research & Therapy, 13(1). https://doi.org/10.1186/s13195-021-00784-w
Medical Disclaimer: The content provided on this blog, including text, graphics, images, and other material, is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The information on this blog is not intended to replace a one-on-one relationship with a qualified healthcare professional and is not intended as medical advice. Please consult your healthcare provider before making any changes to your health regimen.
