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Insulin Resistance: Are You at Risk for Developing Diabetes?


written by Dr. Christine Bishara - Jul 25, 2022

Photo Credit: by Nataliya Vaitkevich, Pexels.com
Photo Credit: by Nataliya Vaitkevich, Pexels.com

The term Insulin resistance is used frequently these days but many do not understand what that actually means. Insulin is a hormone released by our pancreas that facilitates the transport of glucose into cells. Cells need fuel and they use glucose to function. Think of Insulin as the key that unlocks the doors of cells to allow glucose in.

After we eat, our pancreas releases insulin into the bloodstream to start this process of glucose utilization by our cells. Insulin resistance means just that–our cells start to become resistant to insulin and don’t respond as well as they used to, leading to more glucose remaining in the bloodstream and elevated blood glucose levels.

I call insulin resistance “The Boy Who Cried Wolf.” We all know the story of the little shepherd boy who was bored and decided to make up a story to warn his village that a wolf was in their midst. Initially the villagers believed the boy, but after repeating the story numerous times, the villagers began to ignore him until one day a wolf actually appeared but as a result of his repeated erroneous appearances, the villagers do not believe the boy’s cries for help and the flock is destroyed. This is essentially what happens in insulin resistance due to frequent and chronic insulin release.

There are two main factors that contribute to Insulin Resistance:

1- Eating too much. The supply of insulin cannot meet the demands of the high glucose consumed and not enough insulin is released to help transport the glucose into cells causing it to remain in the bloodstream.

2- Eating too often or what some people term grazing throughout the day. The constant insulin release after these meals leads to insulin resistance.

Initially, our body initially tries to cope with this by stimulating the pancreas to release more insulin but since cells are less responsive to insulin, the subsequent increase in blood glucose leads to diabetes. Insulin is also a fat storage hormone, so the excess glucose gets stored as fat. This is why many people who are insulin resistant have a hard time losing weight.

Who’s at risk for Insulin resistance?

1- Individuals with a BMI over 25 are at higher risk of developing insulin resistance and eventually diabetes.

2- A family history of Insulin resistance and diabetes puts certain individuals at higher risk.

3- Physical inactivity. This leads to muscle cells being less sensitive to insulin.

4- Certain conditions that interfere with glucose metabolism such as Cushing’s syndrome, PCOS and metabolic syndrome.

5- Certain lifestyle factors. Highly processed and foods with high sugar content.

6- Sleep. Getting less than 7 hours of sleep can lead to insulin resistance since cortisol is released during sleep deprivation and impacts glucose metabolism. Studies have also shown that night shift workers are more prone to insulin resistance and diabetes mellitus.

A diagnosis of Insulin resistance can be made by checking fasting glucose and insulin levels, as well as checking a HGA1C.

What can you do if you are told that you have insulin resistance?

If you have one of the risk factors noted, work with a doctor and holistic nutritionist to work on modifiable risk factors. Intermittent Fasting is a great way to alter lifestyle changes and decrease your risk of developing Insulin resistance and diabetes mellitus. Some studies have shown that restricted timed eating and intermittent fasting can help.

Despite diet and lifestyle modifications, and because there is a strong genetic component, some individuals develop diabetes mellitus.

The most commonly used medications that can help with diabetes include

1- Metformin: Metformin works by Improving how the body responds to insulin and slows down the conversion of carbohydrates into sugar.

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2- Glyburide is part of a school of medications that works by stimulating the pancreas to make more insulin.

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3- GLP-1 inhibitors: This is a newer class of medications that has been shown to have good benefits for blood glucose control and weight loss. GLP-1 inhibitors work by directly stimulating the GLP-1 receptors in the pancreas to increase insulin production.

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As always, before starting any lifestyle modification or medication, discuss with your doctor what is best for your individual needs.

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