What is insulin resistance? Quite simply, it’s when your cells don’t respond to the hormone insulin and therefore struggle to allow sugar in, leading to high blood sugar and a myriad of other issues.

Why is it important?

Insulin resistance (IR) is hallmark of Type II diabetes. 

As of 2015 Diabetes affected an estimated 1.2 million Australians (based on self-reported data).  Undiagnosed diabetics are expected to increase that number by 25%.   If current trends continue, it is predicted that by 2050, 33% of US adults will have diabetes. That’s a lot of people! 

In this article we’ll outline the biochemistry, the causes and consequences of insulin resistance and outline some steps to improve this crucial area of health.

So keep on reading, unless you’re resistant of course (#terriblejoke).  If you don’t care for the biochemistry, scroll on past and check out the rest of the article.

Biochemistry – Healthy person

In a healthy individual, food is eaten and broken down to it’s smallest components, amino acids (protein), monosaccharides (carbs) and fatty acids (fats).  These components cross the small intestine, into the blood stream.  The monosaccharides are then transported to the liver via the hepatic portal vein.  Let’s look at one of the monosaccharides, glucose, for simplicity.

Upon entering the bloodstream, your pancreas detects that blood sugar is high, and secretes insulin.  Insulin attaches to cell receptors, allowing glucose into the cells.  This allows the cell to breakdown the sugar into energy (glycolysis) and if there is a surplus, store these sugars for later (glycogenesis).

Biochem IR

An insulin resistant individual has a slightly different experience. 

After the glucose enters the bloodstream and insulin is secreted, the cells don’t respond to insulin as well and more glucose will stay in the bloodstream compared to a healthy individual.  This causes the pancreas to secrete more and more insulin until blood sugar is sufficiently lowered.  It means that blood sugar stays higher for longer.

So, just how do cells become desensitized to insulin?

You know when you’re at a party and walk into a loud room? Its unbearable to start with but you eventually you get used to it.

After a night of this, you go home and find yourself shouting at everyone because you can’t hear anything.  Your ears are no longer sensitized to normal volumes.

The same thing happens with our cells.  Being bombarded with high levels of insulin constantly, they become attuned to that amount and over time don’t respond to the previously ‘normal’ levels of insulin.  They need more and more insulin to get the message.

Constantly high levels of glucose in the cells can also lead to insulin resistance.  When the cell is already filled with sugar, and blood glucose is high, insulin doesn’t do an adequate job of shuttling glucose from the bloodstream into the cells.  So, more insulin is secreted until this blood sugar is at an acceptable level.

Why is IR an issue?

First off, won’t somebody think of the pancreas?

The pancreas is in charge of producing and secreting insulin.  If there is a constant demand for high amounts of insulin, the beta-cells of the pancreas start to wear out and die.  This can mean less insulin is secreted in the future, leading to chronically elevated blood sugar.

The high sugar and insulin content of the blood leads to a myriad of other problems including cardiovascular disease, metabolic syndrome, kidney failure, retinopathy, diabetic foot ulcers (with potential amputation) and more.

On top of this, insulin resistance can lead to Type II diabetes, Alzheimer’s disease (also referred to as Type III diabetes) and Polycystic Ovarian Syndrome (PCOS)

Other symptoms include

• Frequent urination

• Increased thirst

• Fatigue

• Reactive hypoglycaemia (low blood sugar)

What are some causes of insulin resistance?

• Extra weight

  • Gone are the days when we believed fat was just for energy storage.  We now know it is responsible for the production and secretion of some hormones, insulin being one of them.

• Diet

  • A diet high in carbohydrates, especially refined sugars and low in fibre and frequent meals can all lead to IR.

• Stress

  • Stress triggers your body to release certain hormones that break down stored sugar in the liver and pump it out into the blood stream. This, in turn stimulates the release of (guess who?) insulin.

• Sedentary lifestyle

• Low muscle mass

• A family history of Diabetes

  • Though this is not the be all and end all

• Much more                        

How will I know if I’m Insulin Resistant or diabetic?

Consult with your primary health care provider if you suspect having diabetes.  I’m also working on an article on testing for insulin resistance and diabetes (watch this space).

What now?

Some therapeutic goals to work towards include

• Improving insulin sensitivity

• Improving insulin production

• Fat loss

• Muscle gain

• Stress reduction

• Supporting affected organ systems

  • Pancreas

  • Liver

  • Cardiovascular system

  • Brain

Fortunately, there are ways to do this including using food, herbs, supplements and nutrients, exercise (and here), stress reduction and periodic fasting (intermittent or extended day).

Do you have diabetes in the family? Have you been tested for it before? If you’re interested read on to see how YOU can do your best to prevent this from occurring.