What Is Insulin Resistance?
Insulin resistance is a complicated health issue that can lead to problems like type 2 diabetes, heart disease, and obesity. This blog aims to help you understand what insulin resistance is, how to recognize it, and what you can do about it.
Definition and How it Happens:
Our bodies make a hormone called insulin to control sugar levels in our blood. When someone has insulin resistance, their cells don’t respond well to insulin, and this leads to more sugar in the blood. Normally, insulin helps cells take in sugar for energy or storage, but with insulin resistance, this process doesn’t work properly. Other signs of insulin resistance include the body responding too much to insulin with low sugar levels or not making enough insulin.
Genetics can make some people more likely to have insulin resistance, but lifestyle choices are also important. Not moving much, eating lots of processed foods and sugary things, and being overweight can all mess up how insulin works. This makes the body need more insulin, putting stress on the pancreas and causing higher blood sugar levels.
Things that Increase the Risk:
Several things can make insulin resistance more likely. If someone’s family has a history of diabetes, they might be at a higher risk. Eating too many refined carbs and fats, not moving around enough, being overweight, and having certain medical conditions like PCOS (Polycystic Ovary Syndrome) can also increase the risk of insulin resistance.
Linked Health Issues:
Insulin resistance is often a sign of other health problems. It can lead to type 2 diabetes, where the pancreas tries hard to make more insulin but can’t keep up. This results in high blood sugar levels. Insulin resistance is also connected to metabolic syndrome, which involves high blood pressure, high triglyceride levels, low HDL cholesterol, and belly fat, all increasing the chances of heart problems.
Non-alcoholic fatty liver disease (NAFLD) is another condition linked to insulin resistance. Too much fat in the liver due to insulin resistance can cause inflammation and harm the liver.
What Can Be Done:
Preventing insulin resistance involves making healthy choices. Regular exercise is crucial to help the body use sugar better. A balanced diet with whole grains, fruits, veggies, and lean proteins is also important.
Managing weight is a big part of preventing insulin resistance. Even losing a bit of weight can really help improve how insulin works in the body.
For those already dealing with insulin resistance, lifestyle changes are key. Medications like metformin might be suggested to make insulin work better. Some drugs that target specific pathways linked to insulin resistance can also be used in certain cases.
We will discuss more about this down the line.
Insulin resistance is a tricky health problem that can lead to serious issues. Knowing how it happens, the things that increase the risk, and the connected health problems is crucial for prevention and management. Making good lifestyle choices, like staying active and eating well, plays a big role in preventing and dealing with insulin resistance. As we learn more about this condition, ongoing efforts in research are needed to find new ways to treat it and improve public health.
How Does Insulin Cause Heart Disease?
Insulin resistance kicks off problems in the body that lead to heart issues in a few different ways. One major way is by messing up how our body handles sugar. When someone has insulin resistance, their blood sugar levels go up, causing inflammation and stress in the whole body. This inflammation makes plaques build up in the arteries, which is a big problem in heart diseases.
Insulin resistance is also linked to a group of issues called metabolic syndrome. This includes things like having a big belly, high blood pressure, high triglyceride levels, low HDL cholesterol levels, and, of course, insulin resistance. All these things together create a perfect environment for atherosclerosis, a condition where arteries get narrow and hard because of plaques.
Insulin resistance messes up how our blood vessels work, too. Normally, insulin helps our blood vessels widen, promoting good blood flow. But when someone has insulin resistance, this doesn’t work well, leading to high blood pressure and putting more strain on the heart.
Insulin resistance also messes with how our body handles fats. It makes the balance between good HDL cholesterol and bad LDL cholesterol go out of whack. This, combined with the inflammation caused by insulin resistance, increases the chances of plaques breaking and causing heart attacks or strokes.
The risk factors for insulin resistance and heart problems often go hand in hand, making things worse. Not moving around enough, eating poorly, and being overweight all contribute to both conditions. Our genes can make things more complicated, making it important to have personalized plans for preventing and dealing with these issues.
Taking care of insulin resistance is super important for preventing heart diseases. Changing our lifestyle by staying active and eating well is a big part of it. Exercise helps our bodies respond better to insulin and keeps our weight in check, making things easier on our hearts. Choosing foods wisely, like avoiding too much sugary and fatty stuff, helps control sugar levels and keeps our cholesterol in balance.
So, all comes down to two key concepts, Cardiovascular Inflammation, and Cardiovascular Plaque, take a look at Dr. Brewer’s YouTube channel to learn more about this, for now, let’s continue talking about insulin resistance.
How Do You Know If You Have Insulin Resistance?
By now you already know that insulin resistance is a crucial health condition that can affect our overall well-being. To properly handle and prevent the problems linked to it, accurately measuring insulin resistance is very important. This essay explores different methods used to check insulin resistance, looking at how good they are, what limits they have, and how they impact healthcare.
Checking Fasting Insulin and Glucose Levels:
One common way to assess insulin resistance is by checking fasting insulin and glucose levels. Fasting insulin shows how well our pancreas makes insulin, and fasting glucose tells us how cells are using insulin to control blood sugar. The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) is a math formula that combines these levels to estimate insulin resistance. However, it might not catch all the changes in insulin sensitivity.
Using the Oral Glucose Tolerance Test (OGTT):
Another useful test is the Oral Glucose Tolerance Test (OGTT). In this test, you drink a sugary solution, and they check your blood at different times for glucose and insulin levels. This helps get a better idea of how your body reacts to sugar. OGTT is good for finding issues not seen in fasting tests, but it takes a long time, making it less practical for regular check-ups.
Insulin Sensitivity Indices:
Some math models, like the Quantitative Insulin Sensitivity Check Index (QUICKI) and Matsuda Index, directly measure insulin sensitivity. They use fasting insulin and glucose levels with other factors for a detailed assessment. While they provide a thorough evaluation, they might be too complex for some clinical settings.
Hyperinsulinemic Euglycemic Clamp:
Considered the best way to check insulin sensitivity, the hyperinsulinemic euglycemic clamp involves giving insulin while adjusting glucose levels to keep them steady. This method directly measures how well insulin helps tissues use glucose. Although it’s accurate, it’s not practical for regular use due to its complexity and invasiveness.
Surrogate Markers:
Other markers, like adiponectin and leptin levels, have been explored to show insulin sensitivity. Adiponectin, linked to fat tissue, goes down when there’s insulin resistance. Leptin, connected to energy balance, can give clues about insulin sensitivity. These markers offer more viewpoints, but factors like inflammation and obesity can affect their usefulness.
Imaging Techniques:
New imaging techniques, such as magnetic resonance spectroscopy (MRS) and positron emission tomography (PET), directly measure insulin sensitivity in specific tissues. MRS looks at fat content in organs, while PET scans show how tissues take in glucose. These non-invasive methods help understand insulin sensitivity at the tissue level.
What it Means for Healthcare:
Checking insulin resistance accurately is crucial for healthcare. Catching it early helps prevent type 2 diabetes and heart disease. It also guides personalized treatments, from changing lifestyles to using medications.
Routine checks for insulin resistance may become part of preventive healthcare, especially for those with known risk factors like obesity, not moving enough, and genetic factors. Early actions, like eating better, exercising more, and managing weight, can lessen the impact of insulin resistance on overall health.
Finding insulin resistance early might also lead to more careful monitoring of related issues, like high cholesterol and high blood pressure, taking a complete approach to healthcare. Targeted treatments based on accurate checks can improve patient outcomes and reduce the burden of diseases linked to insulin resistance.
Here are some numbers for you from the American Diabetes Association:
Fasting Glucose misses 50% of cases of diabetes and prediabetes, A1C misses 70% of cases, Oral Glucose Tolerance Test Misses 10% of cases, and if you add insulin response, the cases missed come as close to 0 as possible.
Why is an OGTT with Insulin Response the best way to assess Insulin Resistance?
Checking How Insulin Works Overtime:
The OGTT with insulin survey is a special way to see how our bodies handle insulin in different situations. Unlike quick checks of fasting insulin and glucose levels, which only show a single moment in our body’s processes, the OGTT looks at how our bodies react to sugar over a period. This helps us understand better how our bodies deal with different amounts and types of carbs we eat throughout the day, like in real life.
During an OGTT, we drink a sugary solution, and they take our blood at certain times to check both glucose and insulin levels. This mimics the time after we eat, giving important info about how our bodies deal with sugar. High insulin levels after eating might show early signs of insulin resistance, even if fasting insulin levels seem normal. This way of checking, known as dynamic assessment, makes the OGTT with insulin survey really good at catching small problems in insulin sensitivity that static tests might miss.
Finding Early Signs of Glucose Trouble:
The OGTT with insulin survey doesn’t just check for insulin resistance; it’s also great at finding impaired glucose tolerance (IGT), which comes before type 2 diabetes. IGT means blood sugar levels are higher than normal but not high enough for diabetes. This test is super helpful because it shows problems in both glucose and insulin responses, making it a strong tool for spotting early issues with how our body processes food.
People with insulin resistance often have trouble regulating glucose, and the OGTT is good at picking up on these changes. By watching how insulin and glucose levels change over time, the test gives a full picture of how well our bodies handle and clear sugar from our blood. Finding IGT early allows for specific actions, like lifestyle changes and careful watching, to stop it from turning into full-blown diabetes.
Understanding Different Levels of Insulin Resistance:
Insulin resistance isn’t the same for everyone; it can be different in how severe it is and how it shows up. The OGTT with insulin survey is great at giving a detailed look at insulin sensitivity that fits each person. This is really important in groups with various genetic backgrounds, where a one-size-fits-all approach might not catch all the different ways insulin resistance can happen.
Differences in insulin sensitivity are common in conditions like polycystic ovary syndrome (PCOS), where insulin resistance is often seen. The OGTT with insulin survey helps understand insulin resistance better in these groups, making it easier to create personalized treatment plans. Recognizing the subtle differences in insulin sensitivity lets healthcare providers tailor help to the specific needs of people with different levels of insulin resistance.
Spotting When the Body Works Extra Hard:
In cases of insulin resistance, our pancreas often tries harder by making more insulin to keep blood sugar normal. The OGTT with insulin survey helps notice this extra effort, which might not show up in quick checks of fasting insulin alone. Seeing higher insulin levels after eating is important to understand how the pancreas adapts to insulin resistance.
This extra insulin effort might show up early, even before fasting glucose levels change a lot. Recognizing this early sign is crucial for stepping in early because it lets healthcare providers address insulin resistance before it gets worse, lowering the risk of complications.
More Realistic Insights into Health:
The OGTT with insulin survey isn’t just a lab test; it tries to copy how our bodies really work when we eat. While fasting checks are good to know some things, they might not catch everything about how insulin works after we eat. The OGTT with insulin survey bridges the gap between lab tests and real-life challenges, showing a more accurate picture of our metabolic health based on our unique daily habits.
So, How Do You Do an OGTT with an Insulin Survey?
You will need a doctor’s order for this test (in some cases), some labs allow paying out of pocket, but be aware, that you might need to explain to them how to do the test; sounds incredible but it is truth, a lot of technicians are not used to do this kind of testing, fortunately here is a quick overview:
The Oral Glucose Tolerance Test (OGTT) with an insulin survey is like a detective tool for checking how well our bodies handle sugar, especially when it comes to insulin resistance. Let’s dive into the details of what an OGTT can tell us and how we figure out the results.
What Happens During an OGTT:
First things first, what’s this OGTT all about? Well, during this test, you drink a special sugary mix containing 75 grams of glucose. After that, they take your blood at different times, usually before you drink the sugar, and then at 1-hour, 2-hour, and sometimes 3-hour marks after. The goal is to see how your body reacts to the sugar challenge.
Checking Fasting Glucose and Insulin:
At the start, they look at your fasting glucose levels, which should ideally be between 70-100 mg/dL to be normal. If it’s too high, it might mean there’s a problem, like impaired fasting glucose or diabetes.
They also check your fasting insulin levels. There isn’t a one-size-fits-all normal range for this, but too much insulin might suggest there’s an issue, like insulin resistance. But figuring this out isn’t straightforward; it depends on different things like the person and the test used.
Watching How Your Body Handles Sugar:
The next steps are the 1-hour, 2-hour, and sometimes 3-hour checks. These show how your body deals with sugar after you drink the glucose. Usually, glucose levels rise after you drink it and then slowly go down as insulin helps cells use the sugar.
At the 1-hour mark, it’s normal for glucose levels to go up, but if they’re super high, it might mean trouble with glucose tolerance or early insulin resistance.
By the 2-hour mark, glucose levels should start dropping. If they stay high, it could be a sign of issues like impaired glucose tolerance or more advanced insulin resistance.
Some tests go for a 3-hour check, especially if the earlier results don’t tell the full story.
Looking at Insulin Responses:
Now, let’s talk about insulin. The insulin survey checks how much insulin matches up with each glucose measurement. In a healthy response, insulin levels go up with glucose to help cells use the sugar.
They also check something called the fasting insulin-to-glucose ratio. A higher ratio might mean the body is making more insulin to deal with reduced insulin sensitivity.
The insulin Area Under the Curve (AUC) looks at the overall insulin response during the test. If the insulin response is slow or not strong enough, it might mean there’s a problem with insulin sensitivity.
Checking Response Patterns:
It’s not just about single measurements; they also look at the whole pattern of how glucose and insulin respond. Normal responses show a quick rise and fall in glucose levels, matched by an increase and decrease in insulin. But if this pattern is off, it might signal issues with how the body handles sugar.
If glucose levels are high with a lot of insulin, it could mean insulin resistance, where the body needs more insulin to keep sugar levels normal.
If glucose levels stay high, and insulin is low, it might mean problems with the pancreas or not enough insulin production.
So in summary, the lab tech will need to draw blood on three separate occasions, fasting, 1 hour and 2 hours, blood for both glucose and insulin should be drawn, remember to remain seated, you might want to bring a piece of candy, some people might have low glucose levels at the end of the test (this because of an increased response to insulin in some cases).
What it All Means:
So, in a nutshell, interpreting OGTT results is like putting together pieces of a puzzle to understand how well your body deals with sugar, especially when it comes to insulin resistance. It’s not just about spotting problems but also figuring out how likely you are to develop type 2 diabetes and heart issues in the long run.
Understanding this helps doctors recommend specific actions early on to reduce those risks. So, an OGTT isn’t just a test; it’s a helpful tool that gives us valuable information about how our bodies handle sugar and insulin.
What To Do To Avoid Insulin Resistance
Insulin resistance might sound tricky, but the good news is, we can manage and even reverse it with a few changes in our lifestyle. This essay explores different ways we can make things better, like what we eat, how we move, keeping a healthy weight, and sometimes using medications.
1. Eating Right:
The food we eat plays a big role in handling insulin resistance. Here’s how we can make smarter choices:
Cut the Sugary Stuff: Lessen how much sugary and refined stuff we eat. They can make our blood sugar go too high. Instead, go for complex carbs with fiber for a steady energy release.
Beware of Stealth Carbs: Things like oatmeal, some breads, nuts and other “healthy” options might have a lot of carbs and can cause your blood sugar to spike, be careful.
Healthy Fats Are Friends: Foods like avocados, nuts, seeds, and olive oil are good for us. They help our body respond better to insulin.
Get Enough Protein: Eating enough lean protein, like from chicken or beans, helps our muscles and gives a steady flow of good stuff.
Meal Timing Matters: Eating smaller meals throughout the day helps keep our blood sugar steady.
Eat to the glucometer: identify what causes your blood sugar to spike, anytime your blood glucose goes above 140 mg/dl, there is clear danger
2. Moving More:
Exercise is like a superhero against insulin resistance. Here’s what we can do:
Aerobic Fun: Doing stuff like walking, jogging, biking, or swimming for at least 150 minutes a week is a great start.
Strength Training: Adding muscle helps a lot. Things like lifting weights or doing push-ups keep our muscles strong.
Keep It Regular: Doing exercise regularly makes a big difference over time.
Pick What You Like: Doing things we enjoy, like dancing or playing sports, makes it easier to stick with it.
3. Watching Our Weight:
Extra weight, especially around our belly, is linked to insulin resistance. Here’s how we can manage it:
Balancing Calories: We need to eat the right amount for our bodies. Eating a bit less helps with gradual and steady weight loss.
Portion Patrol: Eating slowly and paying attention to how much we eat helps stop overeating, especially carbohydrates, I recommend keeping carbs below 100 grams a day.
Nutrient-Packed Foods: Choose foods rich in nutrients to get what our body needs without extra calories.
Get Professional Help: Healthcare pros and some dietitians can help make personalized plans for weight management.
4. Medications Sometimes Help:
In some cases, doctors might suggest medications to make insulin work better. Medicines like metformin, thiazolidinediones, or incretin-based therapies can help our body handle glucose and insulin better. But remember, only pros should decide if we need these meds.
5. Stress Less, Sleep More:
Stress and not getting enough sleep mess with insulin. Here’s what we can do:
Chill Out: Practices like mindfulness or yoga help keep stress in check.
Sweet Dreams: Aim for 7-9 hours of good sleep each night. Poor sleep messes with how our body handles insulin.
Balance Work and Rest: Taking breaks during the day helps manage stress and keeps us from burning out.
6. Stay Hydrated and Make Smart Choices:
Small things like staying hydrated, watching alcohol, and quitting smoking also matter:
Drink Up: Water is the best choice to stay hydrated. Dehydration can mess with blood sugar.
Easy on Alcohol: Too much booze can mess with insulin, so go easy. If we drink, it’s all about moderation, ideally don’t drink it.
Quit Smoking: Smoking messes with insulin and boosts the risk of diabetes. Quitting is a big win for our health.
In a Nutshell:
Making insulin resistance better isn’t just about one thing. It’s about making a bunch of smart choices together. Eating right, moving more, keeping a healthy weight, and managing stress are all part of the plan. It’s not just about avoiding diabetes and heart issues; it’s about feeling good every day.
Remember, everyone is different. So, talking to healthcare pros is a great idea. They can help us figure out what’s best for our unique needs. Taking charge of our health isn’t just good for preventing problems – it’s about having a better, happier life overall. Let’s make those good choices and feel the positive impact!