It Is Not A Disease. What You Need To Know About Insulin Resistance
Insulin resistance horror stories, or why insulin resistance is not a diagnosis and not a disease?
I very often hear from patients that they are in trouble, they have been diagnosed with insulin resistance and need to be treated immediately.
Let’s start with the fact that this is not a disease, but a condition that requires not treatment with any drugs, but changes in lifestyle ( diet, physical activity).
Why did the term ” insulin resistance” appear?
Let’s start with insulin.
Insulin is a hormone that helps glucose and free fatty acids to be absorbed from the blood into the cells. Insulin suppresses the breakdown ( “burning”) of fats and stimulates the synthesis of glycogen.
What is insulin resistance ( IR)? This is a condition when the cells of insulin-dependent tissues ( fat cells, muscle cells, liver cells) respond poorly to insulin, and this does not allow glucose to enter the cells.
In order to ” push” glucose into the cells, the pancreas produces more insulin. That is, it is a condition when more insulin is needed for the assimilation of glucose by cells and to maintain a normal level of glucose in the blood. The pancreas works in an enhanced mode, it is gradually exhausted and there is an increased level of insulin in the blood ( hyperinsulinemia).
What causes insulin resistance?
The main reason is the overload of cells with fat, which activates a number of mechanisms that limit the flow of glucose and fatty acids. One of these mechanisms is a decrease in the number of insulin receptors on the cell surface.
Even a small amount of excess fat disrupts metabolism
Excess insulin slows down the “burning” of fat in adipose tissue ( lipolysis) and contributes to an increase in the amount of fatty acids in the blood and a worsening of their entry into the liver and muscles. Such a ” gyrotoxic” state leads to the fact that the intracellular receptors that transport glucose into the cell begin to malfunction, and insulin insensitivity on the surface of the cell membrane increases even more.
It also happens that IR is present in slightly overweight people, when BMI=26−27 kg/m2. This means that even a small amount of excess fat, especially abdominal fat ( the one around the internal organs), disrupts metabolism.
Stress and insulin resistance
When there is a lot of cortisol circulating in the blood, which is excessively produced by the adrenal glands under chronic stress, it can increase IR.
Insulin resistance, prediabetes and type 2 diabetes
The pancreas cannot work indefinitely in the mode of excessive work, and gradually the cells begin to produce less insulin. And since glucose in the blood does not decrease, it turns into fat and is deposited wherever possible ( under the skin, in the liver, pancreas, etc.).
Excess insulin also does not go unnoticed: it can stimulate the development of some tumors ( endometrial cancer, colorectal cancer, pancreatic and prostate cancer).
High levels of insulin can also stimulate hyperplasia of the thyroid gland, and is also one of the causes of PCOS ( polycystic ovary syndrome).
What has to be done?
Lose weight if you are overweight. This process includes the following.
— More fiber ( vegetables, unsweetened fruits, berries, cereals with shells or bran, flax seeds, nuts).
– Less saturated fat ( preferably lean meat, very moderate lard; avoiding fried, confectionery products).
— Food with anti-inflammatory properties: fresh greens, berries.
— Special emphasis on the low glycemic index of food, exclusion of pure and hidden sugar and fructose ( including honey). Instead of desserts – berries, sour fruit.
— Take breaks between meals: eat something and wait 4-5 hours, drink water, tea, coffee.
Muscle contraction increases the sensitivity of cells to insulin, stimulates the formation of new insulin receptors on the surface of cells, activates internal receptors — glucose transporters in cells. Therefore, walking a lot and doing exercises or dancing is extremely, extremely effective! ( I put as many as two exclamation marks).
What should not be done?
1. Take an insulin test using the PGTT ( oral glucose tolerance test), because in response to a glucose load, the insulin level will rise, which will cause a misinterpretation and a ” diagnosis” of insulin resistance.
In practice, IR can be established clinically ( waist size, body mass index, polycystic ovary syndrome, characteristic blackening of the skin on the elbows and in the folds). Analysis for insulin is justified only when the diagnosis of insulinoma is made.
I remind you again and again: insulin resistance is not a diagnosis, but a condition from which you can get out.
2. Donate blood for the NOMA-IR index: this test is used for scientific purposes, but not for clinical conclusions.
Insulin resistance is not the cause of obesity, but its consequence. To be precise, IR is the protection of the body from overloading with carbohydrates ( glucose) and fat.
Therefore, replace macaroons, napoleons, cakes with cream with berries ( a mixture of blackberries, blueberries, blueberries, etc.) or a glamorous berry smoothie, whipped with flax seeds and 1-2 nuts.
Replace instant porridges with those that need to be boiled.
Lower the glycemic index of food by adding ground bran powder and chopped greens to it.
An Example Of The Daily Menu:
Breakfast: buckwheat porridge with ground oats and rye bran; soft-boiled egg, green and vegetable salad; add olive or unrefined sunflower oil. Black coffee + blackberry and rowan berries.
Dinner: stewed vegetables with lean white fish.
During the day: water, green or black tea.