Understanding Insulin Resistance and Diabetes

According to CDC statistics, more than 37 million people in the United States have diabetes, and 1 in 5 of them don’t know they have it. Type 2 diabetes accounts for approximately 90% to 95% of all diagnosed cases of diabetes. Diabetes is the eighth leading cause of death in the United States (and may be under reported). Medical costs for people with diabetes are twice as high as for people who don’t have diabetes.

If 1 out of 10 Americans are currently diagnosed with Type 2 diabetes, you may be thinking that you have a 90% chance of avoiding the diagnosis but keep in mind that the actual cases may be much higher than what the current statistics show and the number of diagnosed cases keeps growing and its growing fast. The number of adults diagnosed with diabetes has more than doubled in the last 20 years as the American population has aged and become more overweight or obese.

What does it mean to be insulin resistant?

Insulin resistance occurs when the body's cells become resistant to the effects of insulin, a hormone produced by the pancreas that helps to regulate blood sugar levels. As a result, the body produces more insulin to try and compensate for the resistance, but eventually, the pancreas can no longer keep up and blood sugar levels become too high. This is known as type 2 diabetes.

Insulin resistance is an important issue to be aware of because it can lead to a number of serious health problems. Besides diabetes, these include heart disease, stroke, kidney disease, and blindness. 

 First, what is insulin and how does the body use it?

Insulin is a hormone that is produced by the pancreas and plays a crucial role in regulating the amount of glucose (sugar) in the bloodstream. Its main role is to facilitate the uptake of glucose by cells in the body, where it can be used for energy or stored for later use.

Think of insulin like a real estate agent who is trying to match apartments (your cells) with tenants (blood sugar). The apartments need tenants to function so your insulin hormone helps unlock the apartments for tenants to reside in so that they can function. Insulin unlocks the cell’s receptors so that glucose can find its way inside. See Figure 1.

After a meal, when glucose levels in the bloodstream rise, the pancreas releases insulin into the bloodstream. Insulin binds to receptors on the surface of cells, which signals the cells to take up glucose from the bloodstream. Once inside the cells, glucose can be used to fuel metabolic processes or stored as glycogen in the liver and muscles for later use.

Figure 1: Insulin "unlocks" the glucose channel by activating the insulin receptor on the cell

 

Insulin also plays a role in regulating the metabolism of other nutrients, such as fats and proteins. It stimulates the uptake of fatty acids by adipose tissue (fat cells) and the synthesis of fatty acids in the liver. Insulin also helps to promote the uptake of amino acids by cells, which can be used for protein synthesis.

So back to Insulin resistance which occurs when the body's cells become less responsive to the effects of insulin. This can happen due to a number of factors, including genetics, obesity, physical inactivity, and an unhealthy diet.

When cells become resistant to insulin it’s like that apartment building saying we’re all full up and cannot take any more tenants. This poses a problem as all that glucose remains in the bloodstream. It’s kind of like a housing crisis for your glucose as it has nowhere to go. This causes a host of other problems like rigid blood vessels, increased oxidative stress, inflammation, nerve damage, and it can damage the immune system.

 Let’s explore the risk factors that contribute to insulin resistance.

Obesity is a significant risk factor for insulin resistance because it leads to an increase in fat cells, which can release inflammatory chemicals that interfere with insulin signaling. Additionally, excess body fat can lead to the accumulation of fat in organs such as the liver and pancreas, which can also interfere with insulin sensitivity.

Physical inactivity can also contribute to insulin resistance by leading to a reduction in muscle mass, which is an important site for glucose uptake. When muscles are not used frequently, they become less responsive to insulin and less able to take up glucose from the bloodstream.

An unhealthy diet that is high in sugar, refined carbohydrates, and unhealthy fats can also contribute to insulin resistance. These foods can cause a rapid rise in blood sugar levels, which can lead to an overproduction of insulin. Over time, this can lead to the development of insulin resistance.

Getting older is also a factor. As we age, our cells become less sensitive to the effects of insulin, and the pancreas may produce less insulin in response to rising blood sugar levels. This can lead to a condition known as impaired glucose tolerance, which is a precursor to type 2 diabetes.

Finally, genetics also play a role in the development of insulin resistance. Some people may be more genetically predisposed to developing insulin resistance, and this risk can be increased by lifestyle factors such as obesity and physical inactivity.

 What happens when too much blood sugar accumulates in the blood stream?

Like we discussed before, when there isn’t enough housing for people to live, they are relegated to living on the street. The same is true with glucose or blood sugar. If it cannot find cells to live in to be converted to energy or to be stored as fat, the blood sugars are forced to stay on the street or your blood vessels and can cause some havoc on your body by staying there.

The human body is designed to maintain a relatively constant level of glucose in the blood. Glucose is the primary source of energy for the body's cells, and it is tightly regulated to ensure that it stays within a narrow range. When blood sugar levels rise above this range, it can have a range of negative effects on the body.

First, high blood sugar can damage blood vessels throughout the body. The excess glucose can cause the blood vessels to become stiff and thickened, which can reduce blood flow to organs and tissues. Over time, this can lead to a range of complications, including heart disease, stroke, kidney disease, and nerve damage.

Second, high blood sugar can lead to inflammation throughout the body. The excess glucose can cause the body to produce more reactive oxygen species (ROS) and free radicals, which can damage cells and tissues. This can contribute to chronic inflammation, which is associated with a range of diseases, including heart disease, cancer, and autoimmune disorders.

Third, high blood sugar can damage the body's nerves. Excess glucose can accumulate in nerve cells and cause damage to the myelin sheath that surrounds and protects the nerves. This can lead to a range of symptoms, including numbness, tingling, and loss of sensation in the extremities.

Finally, high blood sugar can impair the body's immune system. Excess glucose can weaken the immune system and make it more difficult for the body to fight off infections. This can increase the risk of infections and make it harder for the body to recover from illness.

 Insulin Resistance can lead to Diabetes

Insulin resistance is a major risk factor for developing type 2 diabetes, which is a chronic condition that affects millions of people worldwide.

The word "diabetes" comes from the Greek word "diabainein", which means "to pass through" or "siphon". This refers to the excessive urination and thirst that are common symptoms of diabetes.

The term "diabetes" was first used in the English language in the early 16th century to describe the condition of passing excessive urine. In the 17th century, the English physician Thomas Willis coined the term "diabetes mellitus", which means "honey-sweet diabetes". This name was given because the urine of people with diabetes mellitus has a sweet taste due to the presence of excess glucose.

Today, "diabetes" refers to a group of metabolic disorders characterized by high blood sugar levels over a prolonged period of time. The two main types of diabetes are type 1 diabetes and type 2 diabetes, as we discussed earlier.

Type 1 diabetes and type 2 diabetes are two distinct forms of diabetes that differ in their underlying causes, treatment, and management.

Type 1 diabetes is an autoimmune condition in which the immune system mistakenly attacks and destroys the insulin-producing cells (beta cells) in the pancreas. As a result, the pancreas is unable to produce enough insulin to regulate blood sugar levels, and people with type 1 diabetes require insulin therapy to survive. Type 1 diabetes typically develops in childhood or adolescence, although it can occur at any age. The exact cause of type 1 diabetes is not fully understood, but it is thought to be a combination of genetic and environmental factors. There is currently no cure for Type 1 diabetes, and medications used to treat type 2 diabetes are not effective for treating Type 1 diabetes.

Medicinal options for people that have Type 1 diabetes include insulin therapy. Insulin therapy is the cornerstone of treatment for type 1 diabetes. Insulin can be administered through injections or an insulin pump. The goal of insulin therapy is to mimic the natural pattern of insulin secretion in the body and maintain blood sugar levels within a normal range. Insulin medications can be rapid-acting where it helps control spikes after eating or long-acting where it helps maintain insulin coverage throughout the day and night.

Another medication for Type 1 diabetes is Glucagon which is a hormone that can be used to treat severe hypoglycemia (low blood sugar). Glucagon is typically administered as an injection. Also, Pramlintide is a medication that can be used in combination with insulin to help regulate blood sugar levels. It works by slowing down the digestion of food and reducing the amount of glucose that enters the bloodstream after meals.

Type 2 diabetes differs from Type 1 because it is a metabolic condition in which the body becomes resistant to the effects of insulin, and the pancreas is unable to produce enough insulin to compensate. Type 2 diabetes is the most common form of diabetes, accounting for around 90-95% of all cases. It is often associated with lifestyle factors such as obesity, physical inactivity, and an unhealthy diet, although genetics can also play a role in its development. Type 2 diabetes is typically managed with lifestyle modifications such as diet and exercise, as well as medications to improve insulin sensitivity and regulate blood sugar levels.

Medicinal options for Type 2 diabetes may also include insulin therapy because patients may require insulin therapy to help manage their blood sugar level. Metformin is often the first medication prescribed to people with type 2 diabetes. It works by reducing the amount of glucose produced by the liver and improving insulin sensitivity. It is taken orally and is available in both immediate-release and extended-release formulations. Sulfonylureas are a class of medications that stimulate the pancreas to produce more insulin. They are taken orally and are available in both short-acting and long-acting formulations. DPP-4 inhibitors are a class of medications that increase the levels of incretin hormones, which help stimulate insulin production and decrease the amount of glucose produced by the liver. They are taken orally and include medications such as sitagliptin, saxagliptin, and linagliptin.

GLP-1 receptor agonists are a class of medications that mimic the effects of incretin hormones, which help stimulate insulin production and decrease the amount of glucose produced by the liver. They are taken by injection and include medications such as exenatide, liraglutide, and dulaglutide. SGLT2 inhibitors are a class of medications that block the reabsorption of glucose by the kidneys, which increases the amount of glucose excreted in the urine. They are taken orally and include medications such as canagliflozin, dapagliflozin, and empagliflozin.

It's important to note that medication alone is not enough to manage type 2 diabetes. Lifestyle changes, such as diet and exercise, are also crucial for managing the condition. Additionally, the specific medication or combination of medications used will depend on individual factors such as age, health status, and other medical conditions. We will discuss more about those therapies shortly.

To recap, type 1 diabetes is an autoimmune condition in which the pancreas is unable to produce enough insulin, while type 2 diabetes is a metabolic condition in which the body becomes resistant to the effects of insulin. Treatment and management of the two conditions differ, with type 1 diabetes requiring insulin therapy and type 2 diabetes typically managed with lifestyle modifications and medications.

Insulin resistance is a precursor to type 2 diabetes: When the body becomes resistant to insulin, the pancreas must produce more insulin to keep blood sugar levels in check. Over time, the pancreas may become exhausted and unable to produce enough insulin, leading to high blood sugar levels and type 2 diabetes.

 How does your age play a role in Insulin Resistance?

There is a relationship between insulin resistance and aging. Insulin resistance increases with age and is one of the main factors that contribute to the age-related decline in glucose tolerance.

As we age, our cells become less sensitive to the effects of insulin, and the pancreas may produce less insulin in response to rising blood sugar levels. This can lead to a condition known as impaired glucose tolerance, which is a precursor to type 2 diabetes.

Insulin resistance can also contribute to other age-related health problems, such as cardiovascular disease, cognitive decline, and inflammation. It is thought that insulin resistance may contribute to these conditions by promoting the release of inflammatory chemicals and other factors that can damage cells and tissues in the body.

However, it is important to note that not everyone will experience insulin resistance as they age. Maintaining a healthy lifestyle, including regular exercise and a healthy diet, can help to prevent or manage insulin resistance and reduce the risk of age-related health problems.

 Managing Insulin Resistance

There are several lifestyle changes that can be made to help manage insulin resistance. These include:

1.      Exercise regularly: Exercise is one of the most effective ways to improve insulin sensitivity. Regular exercise helps to lower blood sugar levels and increase insulin sensitivity. Aim for at least 30 minutes of moderate-intensity exercise per day, five days a week.

2.      Eat a healthy diet: A healthy diet that is low in processed foods and high in fruits, vegetables, whole grains, and lean protein can help to improve insulin sensitivity. Avoid foods that are high in sugar and refined carbohydrates.

3.      Lose weight: If you are overweight or obese, losing weight can help to improve insulin sensitivity. Even losing a small amount of weight can make a big difference.

4.      Manage stress: Chronic stress can lead to elevated levels of cortisol, a hormone that can interfere with insulin sensitivity. Managing stress through techniques like meditation, yoga, or deep breathing exercises can help to improve insulin sensitivity.

5.      Get enough sleep: Lack of sleep can disrupt the body's ability to regulate blood sugar levels and can lead to insulin resistance. Aim for at least seven hours of sleep per night.

Insulin resistance is a serious health concern that can lead to a number of serious health problems. Even if you haven’t been diagnosed with diabetes, it is important to understand how your body uses insulin, why it’s important to understand why your body may become insulin resistant and how you can take precautions now so that you don’t suffer from the consequences especially as we age. Lifestyle behaviors such as regular exercise, a healthy diet, weight loss, stress management, and adequate sleep, insulin resistance can be managed and the risk of developing type 2 diabetes can be reduced.

 

About the Author:

Brian Highfield is a Certified Nutritionist and has been in the anti-aging business for over a decade. Brian helps people live extraordinary lives by helping them defy aging on the inside and outside so they can stay healthy and active for as long as possible.

Brian authored the #1 best-selling book in the healthy living space called “Rescuing Longevity. How to take back control of your Healthspan.”

Brian lives in Sarasota Florida with his wife and young son.