Insulin Resistance

By Dr Harold Gunatillake - Health Writer

These two words you find in articles in relation to diabetes. Do you know what they really mean, and how serious it could be in relation to your health and wellbeing?

Insulin is a hormone secreted in specific cells called islet cells in the pancreas gland lying behind your stomach, in the upper part of your abdomen.
Its function, among other things, is to secrete the hormone to match the number of carbs and soluble sugars you consume. If you eat too much of carbs and sweets daily, you do strain the pancreas to secrete more, and that situation insulin could become resistant in acting towards excessive blood sugar.

The most common reason why you get insulin resistance is consuming excessive carbs and foods containing added sugars, on a daily basis. Yes, the pancreas will then increase the production of insulin. With time even with the increased make of insulin, the blood sugar may not be brought to normal levels. This is the situation where we say that the pancreas is strained to produce an inferior less active variety of insulin which is resistant to maintaining a normal sugar level in your blood.

Insulin has no influence on the metabolism of fats and proteins, directly.

The main function of this hormone is a true ‘courier service’ accompanying glucose in your blood to the fat cells, liver, muscles and so on. If the pancreas does not produce sufficient amount to cope with the demand of glucose from digested carbs, then the sugar will accumulate and float in your blood, leading to many complications as seen in people with poor diabetic control. This excess accumulation is called, ‘hyperglycaemia’.

In a situation, where the pancreas secretes insulin more than required and hyper-sensitive, or as in tumours called insulinomas, or when taken an overdose of insulin accidently, the sugar level will drop in your blood. This condition we call, ‘hypoglycaemia, a dangerous situation to be in.
Both these situations could arise among diabetics on insulin therapy.

So long as the insulin secretion goes hand in glow situation with glucose physiologically, the blood glucose level will remain at the normal range.
Your normal fasting glucose level, when checked with your glucometer, will give a reading of a range between 80mm/dl to about 110mm/dl. (5.5mmols).

When your sugar level reaches 126mm/dl, then you qualify to become a ‘pre-diabetic’ by definition, also called ‘spring diabetes’.
You could have no symptoms with insulin resistance, for a long time. The first sign could be dark patches of skin on your neck, elbows, knees, and hands.

Your chance of getting insulin resistance can increase if you do not daily exercise,  have high blood pressure, or smoke. It is possible to get insulin resistance with low HDL (good cholesterol), or high levels of fat (triglycerides) in your blood. You could even end up with heart disease, stroke, and peripheral vascular disease.

Some people may be resistant to insulin due to a history in the family. If your parents have diabetes, it is most likely that you would get insulin resistance.

The easiest test to check whether you have insulin resistance is to take a sample of blood, fasting or otherwise and check the blood sugar level. You could also have a blood test called ‘HbA1c” to check the average level of your blood sugar during the past three months. If the numbers are high, will suggest you have insulin resistance.

Eating too many carbs and sugars strain your pancreas to secrete more insulin. This strain for a long period may produce insulin that could become resistant to glucose. The pancreas may have to work overtime to produce more insulin to compensate for the resistance. If further neglected, the pancreatic cells that make insulin can burn out, leading to diabetes. In such a situation you may need insulin therapy in the injection form to control your blood sugar, on a daily basis.

Your Diet
You need to cut back on processed or refined grains (rice and wheat products), having a high glycaemic index and substitute with vegetables, whole grains, and some fruits. In short, you need to go on a low carb diet (40grams/per day) like the diet formulated by Atkin. The DASH diet, for people with high blood pressure, with low carbs seems to be another preferred one. On the latter diet, you cut down on your salt, too which helps you to lower insulin resistance. Another beneficial diet is the Mediterranean one- uses lots of veggies and fish, chicken, nuts, olive oil whole grains, and legumes.

Watch your calories and glycaemic load (GL), cut back on fried foods, sugary drinks (sodas) and salted processed foods.

Physical activity helps you to lower your insulin resistance. Strength and stretching exercises as in a gym work-out increases glucose absorption for quick energy, and lowers the insulin resistance, too

Lifestyle changes
Lifestyle changes for better with low carb, low fat, high protein diet, with exercise and fresh air are the best treatment for insulin resistance. If you develop diabetes, you may need a drug like metformin to reduce the blood sugar level through the intervention of your liver. This drug also prevents or delays type 2 diabetes for younger obese people.

Metabolic Syndrome
If you are overweight ( a large waist-line), with high blood triglycerides, low HDL (good cholesterol), high blood sugar, and blood pressure, you are categorized as having, ’metabolic syndrome’  Insulin resistance is an important sign of this syndrome, and it raises your chance for diabetes, heart disease, and stroke.

People having insulin resistance have a high level of chronic inflammation throughout your bodies, and more prone to blood clots in your arteries, liver disease, and rheumatoid arthritis, among others.

Conclusions: Changing for a healthier lifestyle and being aware of the condition may help you to avoid insulin resistance.

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