What is insulin resistance?

70 % of Americans are genetically prone to insulin resistance!  A benefit to our ancestors in an environment of scarcity of food and little if any sugar, it is a curse in an environment of plenty, especially processed highly glycemic food.

Our genes have not changed fast enough to adapt to a toxic diet of processed foods designed to make us crave more processed food.  Google “bliss point” to understand how our food supply is being manipulated to our detriment.

The cells of the muscles, fat , and liver become insensitive to insulin causing the body to produce higher insulin levels to compensate.  Eventually insulin production fails and blood sugar levels begin to elevate.  We then declare:  Diabetes!

Even before rising glucose levels are detected, insulin resistance and high insulin levels create inflammation that causes arterial damage.  We call this damage atherosclerosis and it leads to heart attack, stroke, dementia and death.

This graph illustrates the relationship between insulin resistance, rising insulin levels and blood glucose levels associated with the progression from prediabetes to Type 2 Diabetes.

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What are some of the indicators of insulin resistance?

Insulin resistance produces a large waistline, high blood pressure, elevated blood sugar, high triglycerides, low HDL cholesterol (Metabolic syndrome), heart attack or stroke, gestational diabetes, polycystic ovary syndrome, erectile dysfunction, ananthosis nigricans, and periodontal disease for starters

How do we identify insulin resistance?

The best method is a two hour oral glucose tolerance test. Blood is drawn before and after drinking a sugary liquid to see how your body responds to the glucose.  Certain cutoffs define diabetes and prediabetes.  But truly normal glucose levels should be below 125 at 1 hour and 120 at 2 hours. 

We perform body composition analysis on all our patients.  Elevated visceral fat can be detected in a few minutes, revealing some of the earliest evidence of insulin resistance. 

You should know about insulin resistance as early as possible, when a low glycemic diet and exercise can prevent the complications of insulin resistance.

How do we address insulin resistance?

First, cut out sugar from your diet. Excess sugar in your daily diet is stored as fat, exacerbating insulin resistance. Avoid carbohydrates starches and processed foods. Eat vegetables, protein and good fat.  Get your carbohydrates from vegetables.

Exercise, preferably high intensity interval training.  Build muscle with resistance training. 

Get enough sleep each night.  Find ways to release stress to reduce cortisol levels that raise glucose and insulin.

See how body composition testing can help you find out if you are Insulin Resistant

Supplements and Medications for Insulin Resistance and Stubborn Visceral Fat

Sometimes insulin resistance is so severe that a low carbohydrate diet and exercise do not achieve the reduction in fat that one might expect.  This can be due to an incomplete commitment to carbohydrate restriction and insufficient patience.  Once again, we cannot out prescribe a bad diet.  But sometimes a little help is needed.

The highest reported visceral fat measurement on our InBody is 20.  This can actually represent a plateau which may be reflecting visceral fat burdens much higher.  Therefore, perseverance and focus on body fat mass reduction is the key to maintaining motivation and momentum until that number drops below 20.

Insulin resistance and high insulin levels are a vicious cycle.  Rising insulin levels cause ingested glucose to be stored as fat, worsening insulin resistance and leading to rising insulin levels. 

Medications used to treat insulin resistance include pioglitazone and rosiglitazone.  Used in established diabetes, their side effects have limited their use.  But prescribed “off label” to patients with prediabetes, they are well tolerated and are associated with benefits, including improved arterial disease related outcomes.  The weight gain reported with these medications is mostly due to salt and water retention.

Effective supplements include cinnamon, chromium, vanadyl, alpha lipoic acid and biotin.  All support noninsulin dependent pathways for glucose to enter the cell.  This creates less signaling for higher insulin levels and less glucose stored as fat. This would, in theory at least, make fat reduction more likely for any given level of glucose intake reduction. 

Therefore, for those who are struggling to see any decline in their fat, including visceral fat, we can offer these supplements and sometimes medication.  One that we stock in our office, Diaxinol, contains all these supplement ingredients. 

Eventually, these supplements may not be needed.  But they can provide a kickstart for difficult cases.