Insulin resistance

Dr. Anurag Shahi (AIIMS)MBBS,MD

August 29, 2020

August 29, 2020

Insulin resistance
Insulin resistance

With a major festival or wedding almost every single month, it's always time to indulge in a little meetha (sweet) in Indian households. Lockdown or not, the flavour of freshly prepared milk cake or halwa is cherished by everyone.

But should everyone really be having these sweets? If you have ever wondered what happens in the body when you binge-eat ice-cream while watching the hundredth re-run of your favourite movie, read on:

How does the body control blood sugar?

When we eat that tub of ice-cream or a humble piece of bread, the sugar from these foods enters the bloodstream via the digestive tract.

Next, groups of cells called islets of Langerhans on the pancreas produce a hormone known as insulin. This hormone allows glucose to move from the bloodstream into the muscles, fat and liver cells where it is used to produce energy.

In case we have more sugar in our body than it needs, insulin helps store the sugar in the liver. This sugar is then released when our blood sugar level is low, such as in-between meals or during intense physical activity.

Insulin is the hormone responsible for maintaining blood sugar levels in human beings, and problems with this hormone are at the root of many modern-day health problems. High blood sugar, also called hyperglycemia, has particularly toxic effects.

However, the cells in our body sometimes stop responding to insulin correctly. That's when we get insulin resistance.

Read more: What is insulin and how to administer it

What is insulin resistance?

When the cells in our muscles, fat and liver do not respond well to insulin and are unable to make use of the glucose from our blood for energy, the condition is called insulin resistance.

In this condition, one of two things can happen:

  • The pancreas starts producing more insulin, leading to high insulin levels in the blood or hyperinsulinemia. As long as the pancreas can produce enough insulin to cover up for the inadequacy of the muscle, fat and liver cells to take up glucose, blood sugar remains normal.
  • Or, the pancreas fails to increase insulin production adequately, blood sugar levels rise, leading to prediabetes and then diabetes.

Insulin resistance is becoming an increasingly common problem in India and across the world. According to some studies, one in three Americans suffers from insulin resistance. In India, a small study in two localities of Chennai (Chennai urban population study-7 [CUPS-7]) put the prevalence of insulin resistance at over 11%. Another epidemiological study in Western India put the prevalence of insulin resistance syndrome at 12.8%, with a higher incidence among women compared with men.

Insulin resistance symptoms

Insulin resistance may not show any symptoms in the early stages. That said, insulin resistance can be a precursor to and cause of prediabetes and diabetes, and it could show up as:

  • High blood sugar: Blood sugar at prediabetic levels (100-125 mg/dL) or over 125 mg/dL (diabetes) may signify insulin resistance.
  • Hunger pangs and low energy: In people with insulin resistance, glucose from the blood is not able to enter the cells due to which the body is unable to convert food into energy. This may cause hunger pangs even after having heavy meals.
  • Dark skin patches: If you have visibly dark, velvety skin patches on your neck, elbows, armpits, it could be due to acanthosis nigricans which can indicate severe insulin resistance.
  • Skin tags: Some people may also get skin tags, small bumps of extra skin that may be loose and hanging.
  • Metabolic syndrome: If you have high triglyceride levels of (150 mg/dL of blood or more), or are taking medication to control these blood fats, chances are you need to get checked for insulin resistance too. Apart from this, blood pressure readings of 130/85 mmHg or higher, or taking medication to control high blood pressure may also be a symptom associated with insulin resistance.
  • Weight gain, especially around the middle (belly fat)

Insulin resistance causes and risk factors

Genes and lifestyle factors are both risk factors for insulin resistance. Insulin resistance can develop if one or more of the following factors apply:

  • If you are overweight or obese
  • If you have a sedentary lifestyle and take little or no physical exercise
  • If you have been taking high doses of steroids over an extended period of time
  • If you have chronic stress
  • If you have Cushing’s disease or polycystic ovary syndrome

Tips to improve or prevent insulin resistance

Try the following tips to improve insulin sensitivity:

  • Lose weight: Managing weight with a healthy diet and regular exercises has been shown to improve insulin sensitivity multifold. A study, done at the University of New Mexico, School of Medicine, published in the International Journal of Obesity, showed that overweight people who lost 10% of their weight through diet and exercise saw insulin sensitivity improve by a dramatic 80%.
  • Get enough sleep: Researchers found that just one night of sleep deprivation worsened insulin resistance as much as eating high-fat foods. It is therefore important to tuck yourself in bed on time to get seven to eight hours of sleep every night.
  • Avoid refined carbs: Refined carbohydrates have a higher glycemic index (GI). GI is a scale that measures a specific food's capacity to raise blood sugar. Replacing refined carbs with whole foods that have lower GI index and take time to breakdown may result in better blood sugar levels.
  • Do intermittent fasting: Studies have found that intermittent fasting not only helps in creating a calorie deficit but also improves blood glucose levels. However, it may not suit everyone. Consult a dietitian or medical practitioner before doing these fasts.
  • Drink green tea: Green tea is the healthiest beverage on the planet and has various antioxidants. Several studies have shown that consumption of green tea over a period of time can reduce insulin levels.
  • Eat fatty fish for lunch or dinner on most days: Fish like salmon, herring, anchovies, among others, are highly beneficial for a number of health conditions, including improving insulin resistance. (Read more: Best fish to eat in India)

Insulin resistance takeaway

High blood sugar levels need to be tackled cautiously. A good lifestyle involving healthy food, 150 minutes of exercise per week and an appropriate amount of sleep can not only improve one’s quality of life, but they also help increase insulin sensitivity in the body.



References

  1. Bouchonville, M., Armamento-Villareal, R., Shah, K., Napoli, N., Sinacore, D. R., Qualls, C., & Villareal, D. T. Weight loss, exercise or both and cardiometabolic risk factors in obese older adults: results of a randomized controlled trial. International journal of obesity (2005), 38(3), 423–431. https://doi.org/10.1038/ijo.2013.122
  2. Mesarwi, O., Polak, J., Jun, J., & Polotsky, V. Y. (2013) Sleep disorders and the development of insulin resistance and obesity Endocrinology and metabolism clinics of North America, 42(3), 617–634. https://doi.org/10.1016/j.ecl.2013.05.001
  3. Liu CY, Huang CJ, Huang LH, Chen IJ, Chiu JP, Hsu CH. Effects of green tea extract on insulin resistance and glucagon-like peptide 1 in patients with type 2 diabetes and lipid abnormalities: a randomized, double-blinded, and placebo-controlled trial PLoS One. 2014 Mar 10;9(3)
  4. Ramel A, Martinéz A, Kiely M, Morais G, Bandarra NM, Thorsdottir I. Beneficial effects of long-chain n-3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults Diabetologia. 2008;51(7):1261-1268.

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