What Does Insulin Resistance Mean?
Fewer people smoke, people are living longer, and we have the latest state of the art medical treatment for heart disease, stroke, and cancer. Can you believe people are still unhealthy, and overweight? 80 percent of type 2 diabetics are overweight, and type 2 diabetes is past epidemic proportions. Obesity, insulin resistance and type 2 diabetes are they related? What does insulin resistance mean?
Insulin receptors are discovered on cell membranes. This discovery raises the possibility that missing or defective insulin receptors may prevent glucose from entering the cells. Thus contributing to the insulin resistance of type 2 diabetes. From the history of the American Diabetes Association.
Fast forward to 2017
Even though medicine is so advanced, people do not look like they did before. Do not feel as good, and are suffering from serious medical problems. People have different shapes than before, bigger bellies, and bigger abdomens. They are obese. (Obesity means being at least 20 percent over the ideal body weight for one’s height, build, and sex.). Thin people have potbellies. Obesity is out of control! The cause is the hormone insulin.
Discovery of insulin
Fredrick Banting, Charles Best, and John Macleod discovered insulin at the University of Toronto in 1921. They first tested on dogs, successfully. Needing more insulin, they used cows. In late 1921 a biochemist Bertram Collip, joined the team, who purified the cows insulin for human use. In January of 1922 they injected Leonard Thompson a young 14 year old, with type 1 diabetes.
The test was a success, otherwise he was near death and would surely have died. Type 1 diabetes before 1922 was a death sentence. He regained his strength and appetite, then went on to live another 13 years.
Later on they tested the insulin on other diabetics with the same success. In 1923 the Nobel Committee awarded Banting and Macleod the Nobel Prize in Physiology or Medicine. Type 1 diabetes was a fatal disease due to diabetic ketoacidosis (DKA), a buildup of acids in the blood. Blood sugar is very high and the cells cannot convert into energy due to a severe lack of insulin.
Instead fats in the body will be burned for fuel. Burning the fats produces acid called ketones, if there is no insulin this process will go on and build up in the blood. High amounts of ketones will be excreted with glucose in the urine. Weight loss and the chemical balance of your entire system will collapse. You will become very ill, very quick.
Symptoms include confusion, rapid breathing, abdominal pain, a fruity smell to one’s breath, and or go into a coma. Insulin must be is administered, or death is imminent. Type 1 diabetes is now a chronic disease treated with insulin.
What is Insulin?
Let’s start at the pancreas, a large gland about the size of your hand, located below the stomach behind the abdominal cavity. It is responsible for manufacturing, storing, and releasing the hormone insulin. The pancreas also makes several other hormones, as well as digestive enzymes naturally. We all have to have insulin to survive.
Insulin is a hormone produced by the beta cells of the pancreas. The main function is to regulate the level of glucose in the blood stream. By facilitating the transport of blood glucose into all of the billions of cells in the body.
Insulin stimulates glucose transporters to move to the surface of cells to allow glucose entry into the cells. Like a key unlocking a lock. Insulin also stimulates centers in the hypothalamus of the brain responsible for hunger and satiety. As we begin to eat insulin secretes before glucose hits the bloodstream.
Insulin also instructs fat cells to convert glucose and fatty acids from the blood into fat. The fat cells then store until needed. Insulin is an anabolic hormone. It is essential for the growth of many tissues and organs. In excess, it can cause excessive growth, for example, of body fat and of cells that line blood vessels.
Finally, insulin helps to regulate, or counter-regulates, the balance of certain other hormones in the body.
Insulin As A Storage
When you eat, processed foods/carbohydrates/proteins the pancreas secretes the hormone insulin. To help move the sugar (glucose) into your cells, where it’s used for energy. Glucose and sugar will be used interchangeably. Excess glucose is either stored in the liver as glycogen where it will be used later as the body needs it, or turns it into fat.
The liver has limited space and has room for a limited amount of glycogen. Any excess glucose is turned into fat by a process called De Novo Lipogenesis (DNL). Which means “to make new fat.”
Insulin tells the excess glucose to be stored as new fat, called triglyceride molecules. The fat is exported out of the liver to be stored in fat cells later supplying the body when needed. Insulin provides the signal to stop burning glucose and fat, resulting in storage.
Glycogenolysis, takes the glucose from glycogen and will send the glucose to parts of the body where energy is needed. So when feeding and insulin is high there is a balance, when fasting and insulin is low, the result is no weight gain. The result is a metabolically healthy system and provides glucose for short term fasting, up to 36 hours.
Gluconeogenesis is the opposite of the glycogen process and will take the stored fat in the liver in times of prolonged fasting and not eating.
Another factor of insulin, when the liver has a full limited supply of glycogen, there will not be room for DNL. These triglyceride molecules are packaged together with specialized proteins, called lipoproteins, which are made in the liver and exported into the bloodstream as Very Low-Density Lipoprotein (VLDL).
Insulin activates the hormone LipoProtein Lipase (LPL), which signals fat cells, called adipocytes. The adipocytes remove the triglycerides from the blood for storage as body fat.
On the other hand, if the body cannot burn off the excess glucose, the pancreas secretes even more insulin to overcome this resistance. This forces more glucose into the overflowing cells to keep blood levels normal. The effect is temporary as there is still excess glucose. As a result, it has moved the excess from the blood to the cells, making more insulin.
Even though insulin is still secreting, the insulin cannot force anymore glucose into the cells. We then say that the body has become insulin resistant, insulin does not know any better. It is a hormone reacting the way it should. The primary problem is that the cells are overflowing with glucose. The insulin resistance cycle continues until it reaches a stage of too much glucose. There are many metabolic problems that may develop along the way.
If you don’t burn off that glucose, then over a long period, it could be years or decades. Cells become filled and cannot handle anymore. The next time you eat sugar, insulin cannot force anymore glucose into the filled cells. It has nowhere to go, so the excess stays in the blood. When there’s too much glucose in the blood, insulin does not appear to be doing its job of moving the sugar into the cells.
The high blood glucose is only part of the issue. Not only is there too much glucose in the blood, there’s too much glucose in all of the cells. Too much glucose leads to prediabetes and then type 2 diabetes. Kids as young as 3 years old are developing type 2 diabetes, so the insulin resistance cycle is now elevated at months rather than years.
Jason Fung says that he can make you fat by prescribing insulin. Excessive insulin causes weight gain and obesity.
Excessive Insulin Drives Obesity
Constantly eating and snacking will result in your insulin secretion predominating over your recover period. The myth of eating 6 times a day will not allow you to fast. This means that the insulin dominance leads to fat accumulation. Too much insulin means more new fat via DNL.
Normally, if the feeding periods of high insulin balance the periods of low insulin (fasting), there should be harmony, weight remains stable. High insulin tells the body to store food energy as body fat. Eating and not allowing the body to recover from insulin will never allow you to be thin.
Our hormones, mostly insulin, ultimately set our body weight and level of body fat. Remember, obesity is a hormonal imbalance, not a caloric one. Says Jason Fung taken from his book The Diabetes Code.
It is a known fact that if people are given insulin and or cortisol they will gain weight. When stopped they lose weight.
Carbohydrate-Insulin Model of Obesity (CIM)
According to Dr. David Ludwig the Carbohydrate-Insulin Model of Obesity (CIM), the following are true and drive weight gain.
1. Processed carbohydrates — think white bread, white rice, potato products, low -fat snacks — raise insulin more than any other food, calorie for calorie. This is just Nutrition, 101.
2. Insulin is the Miracle-Gro for your fat cells. A child with new onset type 1 diabetes — unable to make enough insulin — will invariably lose weight until receiving treatment, no matter how many calories consumed. Give that child the right amount of insulin, and weight trajectory returns to normal. Give that child (or an adult with type 2 diabetes) too much insulin and excessive weight gain will predictably result. This is just Endocrinology 101.
3. When too many of the calories we eat get locked away in fat cells, there aren’t enough calories to supply the needs of the brain and other organs. So we get hungry and “overeat.” And to make matters worse, metabolism slows down, further fueling weight gain. This is just Obesity 101.
There is a bit more information that needs to be studied and incomplete according this study. The 3 points are the basis for the CIM but there are other factors that contribute to the model. These factors include medication, drugs, stress, smoking, lack of sleep and much more.
Drug Resistance (Tolerance)
Insulin resistance has the exact same analogy as any other resistance or tolerance.
When cocaine is taken for the first time, there is an overwhelming reaction of the “high.” With each use of the cocaine, this high decreases progressively. The users may increase the dose to achieve the same high. Repeated use and prolonged exposure, will develop resistance to the drug’s effects, this is a condition called tolerance (resistance). People build up resistance to many types of drugs, including heroin, marijuana, nicotine, caffeine, and alcohol. Constant use builds resistance.
Removing the drug removes the resistance. Stop drinking alcohol for a long period, say for a year, the first drink afterwards will have its full effect again.
The term insulin resistance has been around since the seventies. Doctors should be able to diagnosis and treat it if they know what to do. The world is experiencing an epidemic of insulin resistance. A third or more of the American population develops it by the time they turn forty.
Kids, teens and young adults have insulin resistance. The reason is due to the sodas and energy drinks available everywhere. Insulin resistance is now a precursor to type 2 diabetes.
People of yesterday had no problems with insulin resistance because they did not eat the processed, refined carbs that we consume today. Diets, workout at the gym and medication are not needed. You need to reduce the amount of insulin your body produces. If you understand this, it should be a piece of cake, pardon the pun.
Now is a good time to get a bloodwork done and the only person who is in control of that is you. Get it done and out of the way. If you have had it done, you know what your A1c is, and then you can monitor your fasting glucose on a daily basis.
People nowadays eat too much starch, sugar and processed refined carbs; hundreds of times more glucose than our prehistoric ancestors did. Our ancestors did not have diabetes because they did not eat process refined carbs.
Some people are the few lucky ones, the others do not handle high glucose so well. The result is obesity, insulin resistance, and many other metabolic complications.
High levels of insulin in the blood down-regulate the affinity for insulin that insulin receptors all over the body have naturally. This “tolerance” to insulin causes even greater insulin resistance.
In his American Diabetes Association Banting lecture in 1988, Gerald Reaven used the term “Syndrome X” to describe the relationship of insulin resistance, hypertension, type 2 diabetes and cardiovascular diseases. Insulin resistance is such a high predictor of age related diseases.
Known as Reaven’s Syndrome, Syndrome X, Dysmetabolic Syndrome, Multiple Metabolic Syndrome, Diabesity, Metabolic Syndrome X, Metabolic Mayhem, Cardiometabolic Syndrome, Visceral Obesity Syndrome, Prediabetes, and Insulin Resistance Syndrome. Call it whatever you want they all mean the same thing.
Untreated Metabolic Syndrome can increase the risk factors to many chronic illnesses. We now know that eating processed foods (for example sodas, sweets, pastas, and breads) can raise glucose, triglyceride and insulin levels. Also, elevated insulin can promote obesity and high blood pressure. The problems are related and occur in clusters, as a result form a syndrome.
Metabolic Syndrome is a disorder that can affect anyone, young, old, and can remain hidden for years, even decades. The symptoms include fatigue, poor mental concentration, abdominal
(apple-shaped) obesity, inflammation, nerve damage and a craving for sugary carbs.
Metabolic Syndrome is defined as the presence of any three of the following:
1. Low HDL Good Cholestrol HDL-C < 40 mg/dl – 1.03 mmol/L in men, < 50 mg/dl – 1.29 mmol/L in women.
2. High Blood Triglycerides TG > 150 mg/dl – 169 mmol/L
3. Abdominal obesity visceral (Large waist size) BMI > 30 kg/m2
4. Hypertension systolic blood pressure > 130 and or diastolic > 85 mm HG
5. Impaired fasting glucose > 110 mg/dl – 6.11 mmol/L
Measure Insulin Resistance
Insulin resistance can be measured only after a blood workup. The best way to measure insulin resistance is through the HOMA-IR test.
The National Cholestrol Educational Program defines Insulin Resistance as the following:
TG > 150 mg/dl HDL-C < 40 mg/dl
BMI > 25 Glucose > 110 mg/dl
The culprit is a particular kind of body fat. Visceral obesity is a type of obesity in which a special kind of fat is concentrated around the middle of the body. Particularly surrounding the organs for example the liver. Males who are viscerally obese have a waist of greater circumference than the hips.
Females who are viscerally obese will have a waist at least 80 percent as big around as her hips. All obese individuals and especially those with visceral obesity are insulin resistant. The ones who eventually become diabetic are those who cannot make enough extra insulin to keep their blood sugars normal.
Body Mass Index – BMI
Is a measure of a persons weight in relation to his or her height.
Calculate using either of these formulas
BMI = weight in kilograms/height in meters squared or BMI = (weight in pounds x 703)/height in inches squared.
Another method of checking obesity is to measure fat at the belly button. How does it look?
How much can you pinch? Can you pinch an inch?
Type 2 diabetes risk may be incrementally higher in those with a higher BMI.
The US department of health considers a person with an index of :
- 19 to 24.9 Normal
- 25 to 29 Overweight
- 30 to 39 Obese
- 40 + Morbidly Obese
Joseph R Kraft
I stumbled across this fantastic book “The Diabetes Epidemic and You” by Dr. Joseph R Kraft. He was the pioneer of the insulin assay and decoded hyperinsulinemia. Dr. Kraft measured people for Insulin/Diabetic issues. 14,384 people ranging from 3 to 91, for 20 years.
Testing was based on an oral glucose tolerance testing (OGTT), glucose is measured in response to drinking glucose. This response identifies how much the body metabolizes and removes glucose from the blood. Important information for diabetes and other metabolic issues.
Dr. Kraft’s tests were different and thorough. First, rather than monitoring glucose for 2 hours, he would monitor for at least 4 and 5 hours. Second, he measured insulin, as well as glucose, over the entire test. Hyperinsulinemia means the same as insulin resistance.
He accurately quantified Type 2 Diabetes in each person. Surprisingly, the prevalence was far higher than perceived from standard tests. He measured their Insulin response to a glucose load, and noticed that there were 5 different patterns of response.
The first group ‘Pattern 1’ is healthy or ‘Euinsulin’ a small percentage were in this group. Within the first hour the insulin will peak and it is back to the baseline, normal pattern. The next Pattern 2, shows insulin resistance and would be overlooked if you just looked at glucose dropping off.
Patterns 3 and 4 show different levels of insulin resistance. Patterns 2 – 4 mean that you are diabetic, his term called ‘Diabetes In-Situ’. Diabetes In-Situ means normal glucose response to abnormal insulin response. My thanks to Ivor Cummins for the diagram.
Pattern V could be type 1 diabetes, is a beta cell failure in the pancreas and cannot generate insulin. Another possibility is a healthy person on a low carb diet. The diagnosis in this case is left to the experts.
Dr. Kraft through his pathology and observations, summarized that:
1. Diabetes can be detected earlier.
2. Abnormally high insulin levels damage the vascular system, and affect every organ in the body.
3. Hyperinsulinemia is a condition and the causal mechanism behind metabolic and chronic diseases.
Once the medical establishment standardizes the test, it would benefit everyone.
I highly recommend you read his book.
How to Reduce Insulin Resistance
1. Reduce added sugar, eliminate desert, if you have to have desert eat nuts, apples, dark natural chocolate (not milk chocolate).
Do not replace sugar with artificial sweeteners, sugar additives, agave or anything similar. No snacking, surprisingly you will save money.
2. Reduce consumption of refined grains, white flour, refined carbs, pasta, and concentrated grain. Eat carbs in the whole natural state. Processed foods increase blood glucose very quickly along with insulin. Follow the Low Carb High Fat diet this is a natural and healthy way of eating
3. Moderate protein in your diet to 20 to 30 % of total calorie intake. No protein shakes, protein bars, protein supplements and processed anything.
4. Increase consumption of natural fats, for example butter, olive oil, coconut oil, nuts, full fat dairy whipping cream, and avocados.
5. Increase consumption of fiber – nuts, natural whole foods, beans, chia seeds, avocadoes, egg plant, and apples.
6. Timing is everything. Eat and fast, try to fast for 20 – 24 hours 2 days a week and 14 to 18 hours for 5 days. You will find that fasting burns fats, lowers blood glucose and normalizes insulin.
7. Try to get 7 to 8 hours of sleep everyday, doing so will keep the cortisol levels in check to reduce blood glucose and insulin.
8. Stop consuming alcohol, drugs and smoking in order to reduce insulin secretion.
Following these points will give you a better chance with insulin resistance. Consult your doctor or health practitioner before making any change(s) to your lifestyle.
Have a look at these videos and then you can answer my questions.
Video by The Fat Emperor Ivor Cummins – ‘The Pathways of Insulin Resistance: Exposure and Implications‘ .
Video by Dr. Hallberg – Carbohydrate Intolerance, Insulin Resistance and Reversing Diabetes .
Do you understand the meaning of insulin resistance? What does insulin resistance mean? Should you be checked?
I welcome and appreciate any comments, questions or concerns. Please send me an email.
Many thanks for dropping by and reading this post.
2. The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally, Jason Fung, Greystone Books, 2018. p47.
6. Diabetes Epidemic and You, Joseph R Kraft, Trafford Publishing, 2008.