Insulin Resistance

Insulin resistance has been an increasing concern over the last 5-7 years. It is the resistance to the hormone insulin, resulting in increased blood sugar. The two hormones connected with blood sugar are insulin and glucagon.


Both are hormones that help regulate the levels of blood glucose, or sugar, in your body. Glucose, which comes from the food you eat, moves through your bloodstream to help fuel your body. Insulin and glucagon work in what’s called a negative feedback loop. During this process, one event triggers another, which triggers another, and so on, to keep your blood sugar levels balanced.


During digestion, foods that contain carbohydrates are converted into glucose. Most of this glucose is sent into your bloodstream, causing a rise in blood glucose levels. This increase in blood glucose signals your pancreas to produce insulin. Insulin tells cells throughout your body to take in glucose from your bloodstream. As the glucose moves into your cells, your blood glucose levels go down. Some cells use the glucose as energy. Other cells, such as in your liver and muscles, store any excess glucose as a substance called glycogen. Your body uses glycogen for fuel between meals.


Glucagon works to counterbalance the actions of insulin. About four to six hours after you eat, the glucose levels in your blood decrease, triggering your pancreas to produce glucagon. This hormone signals your liver and muscle cells to change the stored glycogen back into glucose. These cells then release the glucose into your bloodstream so your other cells can use it for energy. This whole feedback loop with insulin and glucagon is constantly in motion. It keeps your blood sugar levels from dipping too low, ensuring that your body has a steady supply of energy.


Insulin resistance is when the liver and muscle cells stop responding properly to insulin.

The initial response of the pancreas is to make more insulin to help glucose enter cells, but the pancreas usually cannot keep making more and more insulin to overcome the insulin resistance. Eventually the insulin-producing cells of the pancreas start to burn themselves out and blood glucose levels start to rise


So what happens if you continually have high blood sugar and are insulin resistant?

Symptoms:

· extreme thirst or hunger.

· feeling hungry even after a meal.

· increased or frequent urination.

· tingling sensations in hands or feet.

· feeling more tired than usual.

· blurred vision

· frequent infections.


Conditions that insulin resistance can lead to:

- Pre-diabetes

- Type II Diabetes

- Obesity

- Cardiovascular disease

- Overworked and dysfunctional pancreas (will not produce enzymes to break down nutrients as effectively) and liver (will not metabolize nutrients and / or medications effectively)



Can you test for this?

There are two blood tests that the doctor will request. One is a glucose test and the other is your A1C. You will need to be fasting for these tests. The glucose test will test the amount of sugar in your blood at that moment. A1C will test the amount of sugar in your blood over the previous 3 month period. A1C is what most doctor’s will refer to more. A healthy A1C level is under 5.7.



What is the main cause of insulin resistance?

- Obesity

- Increased visceral fat around your organs in abdominal area

o A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance

- Not eating a balanced diet: proteins, fat, carbs


Foods to help prevent and decrease insulin resistance:

- fibrous foods: beans / lentils, vegetables. Whole grains

- veggies: green leafy veg (kale, spinach, arugula, collard greens, beet tops, mustard greens)

- beans: black, pinto, kidney, chickpeas

- lentils: red, green, brown, yellow

- whole grains; oats, quinoa, barley

- Proteins: poultry fish (salmon, white fish: snapper, magi, grouper, etc)

- Omega-3 rich foods: nuts, seeds, salmon (SMASH)

- Foods low on glycemic index / glycemic load

o Certain foods raise your blood sugar levels more significantly than others. Foods low on glycemic load scale do not spike sugars as high as are recommended

- Eat more resistance starches

o Can boost digestion, prevent diseases, improve response to insulin and promote weight loss. While most starches are digested and broken down, resistant starch will pass through you unchanged until they hit your large intestine.

o Resistant starch is a type of carbohydrate that doesn’t get digested in your small intestine. Instead, it ferments in your large intestine and feeds beneficial gut bacteria.

o Rice that has been cooked and cooled (brown over white). Reheated rice will keep the resistant starches

o Whole grains such as barley and oats

· Old-fashioned overnight oats (uncooked) have more resistant starch than cooked oats

o Plantains

o Green bananas (not yellow or ripe bananas, which have regular starch)

o Lentils

o Cassava flour – made from the root yuca found mainly in south America


Sleep and Insulin Resistance

  • Decreased sleep is a risk factor for increased blood sugar levels. Even partial sleep deprivation over one night increases insulin resistance, which can in turn increase blood sugar levels. As a result, a lack of sleep has been associated with insulin resistance and diabetes

  • Cortisol (our flight or fight hormone. Or our hormone that increases our focus and awakeness) is increased by sleep deprivation and increases glucose

  • Oxidative stress and inflammation are increased by sleep deprivation and impact glucose

  • Sleep disordered breathing (like sleep apnea) associated with higher glucose levels

  • And vice versa: increased glucose and insulin negatively effects sleep. This might be because individuals with insulin resistance, have increased weight and lays heavier on organs which in turn creates less O2. More research is needed on the “why” insulin negatively effects sleep


Resources:

https://www.cdc.gov/diabetes/basics/insulin-resistance.html


https://glycemicindex.com/


https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance


https://www.sleepfoundation.org/physical-health/sleep-and-blood-glucose-levels#:~:text=Decreased%20sleep%20is%20a%20risk,diabetes%2C%20a%20blood%20sugar%20disorder.



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