All About Insulin!

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How often feel hungry soon after a meal? Are you always craving more food and end up binge eating? 

You may be suffering from insulin resistance! 

Well, ever heard of the term insulin? Does this intrigue you? 

If yes, join us on this ride of knowing and understanding “All About Insulin!”

What is Insulin?

Ever wondered what happens in your body after you eat your favourite candy or a chocolate bar? 

Your favourite foods like chocolate bars, candies, breakfast cereal, juices, etc are high on carbohydrates. Once these carbs are broken down by the body, a simpler product, glucose is produced. Then, glucose is absorbed by your muscle cells with the help of a hormone called Insulin secreted by the beta cells of the pancreas. This results in providing energy to the cells to carry out their functions regularly. But, what happens when insulin fails to do its job? Does it cause a disorder? Can it be restored or is it life-long? Read on to find the solution to these queries!

What is insulin resistance?

We’ve understood that the body utilises insulin to help in the uptake of glucose by the muscle cells. When the functioning of insulin is hampered, it results in a condition known as “Insulin Resistance” and over time it leads to Type 2 Diabetes mellitus (hyperlink to the article on T2DM)

Insulin resistance (IR) is a disorder, wherein, your cells do not respond to the secreted insulin and your blood glucose does not get absorbed by the cells to release energy. To combat this situation, your pancreas secretes more insulin, and eventually, your blood sugar levels soar high. 

What are the predisposing factors for insulin resistance? 

The causes of insulin resistance are multi-factorial and the majority owe to a poor lifestyle. 

This may happen due to various reasons, such as,

  • A large waist as a result of overweight or obesity 
  • Lack of physical activity
  • Failure of the pancreatic beta cells
  • A high carb diet for a long time
  • Genetic inheritance

Now, let’s go ahead and take a look at how these causes show up in your body as warning signs.

What are its symptoms? 

The commonly experienced signs and symptoms of insulin resistance are,

  • High blood glucose levels
  • Tiredness and exhaustion 
  • Frequent need to pass urine
  • Extreme thirst and hunger.
  • Dark patches on the neck (also known as acanthosis nigricans)
  • High triglyceride levels
  • Low HDL and high LDL levels

Are you prey to these symptoms too? Do you end up snacking more often and still can’t feel full? How do you know if this isn’t normal? 

There are certain tests that determine whether or not you have insulin resistance and they also tell you its severity. 

How to detect it?

The gold standard to assess and diagnose insulin resistance is HOMA-IR, short for homeostasis model assessment-estimated insulin resistance. The other commonly used tests are, blood glucose profile which consists of Fasting blood glucose, postprandial blood glucose (test to detect your blood glucose 2 hours after a meal) Random blood glucose, and HbA1c. The higher the level of glucose in your bloodstream, the greater is the insulin resistance by the cells in your body. 

By now, we’ve understood the basics of insulin resistance. Let’s take a deeper look into the various blood parameters that are impacted due to insulin resistance.

HOMA-IR is the test to detect insulin resistance and its level of severity. It assists in the assessment of the beta-cell function of the pancreas and your body’s sensitivity to insulin from fasting glucose and insulin concentrations. It is also used to track changes in insulin sensitivity and beta-cell function to examine the natural history of diabetes. The normal range for which is <3. Anything in the range of 3-5 shows moderate risk and a value greater than 5 indicates severe insulin resistance. 

Along with HOMA-IR, Fasting insulin and Fasting glucose are measured too. 

Fasting insulin is a measure of the level of insulin in your blood. Fasting insulin outside the normal range increases your risk of developing type 2 diabetes or Metabolic syndrome. Research suggests that a fasting insulin level between 5-10 mlU/l is considered normal. 

Fasting blood glucose (FBG) is estimated in the morning on an empty stomach. It helps your doctor determine whether you are at risk of pre-diabetes or Diabetes Mellitus. A normal range for which is 70-100 mg/dl. If your FBG is between 100-125 mg/dl, it indicates that you’re prediabetic and requires immediate action to prevent its progression to type 2 diabetes mellitus. 

As we have previously seen that obesity is one of the predisposing factors for insulin resistance, it is of paramount importance to assess your level of blood cholesterol and triglycerides. A deranged blood lipid profile is also a diagnostic tool to determine the risk of insulin resistance. 

If your LDL cholesterol is higher than 100 and HDL cholesterol is lower than 40, and triglycerides are greater than 150 mg/dl, it not only indicates your body’s reduced sensitivity to insulin but also, determines your increased risk for cardiovascular diseases as a co-morbidity.

You have fully understood the relationship between insulin resistance and its impact on blood glucose and lipid profile. But do you know that your poor lifestyle is a predisposing factor to all these signs and symptoms? Want to know how the food you eat and the exercise you ignore can have a detrimental effect? Read the next section to know the role of diet, exercise and lifestyle habits on insulin resistance. 

Role of Diet, Exercise, and Lifestyle

Insulin resistance is associated with a high amount of refined grain composition which leads to the burden of increasing your blood glucose to a higher level. A diet rich in cereals such as rice, and refined wheat flour, ice creams, deep-fried processed food, candies, chocolates has detrimental effects on one’s insulin sensitivity. A typical high fat, high carb cuisine like burgers and pasta, pizza loaded with cheese and large portions, increase the risk of visceral fat (fat deposition around the vital organs like heart, lungs, liver, etc.). These foods also have a serious impact on LDL and HDL cholesterol. This in turn reduces the reception of insulin by the cells which leads to insulin resistance and the cycle of elevated blood glucose and reduced insulin sensitivity continues. 

Physical activity has a prominent effect on your insulin sensitivity. During exercise, your body burns glycogen, the stored form of glucose in your liver and muscles. After exercise, your muscles replenish their glycogen stores (glycogen is the stored form of glucose in the liver and muscles) with excessive glucose from the bloodstream. The more glycogen that is burned during a bout of activity, the longer the body’s insulin sensitivity is improved. Thus, to improve your sensitivity to insulin, it is recommended to perform a minimum of 30 minutes of physical activity for 4-5 days consistently. 

Poor lifestyle patterns such as lack of exercise and sedentary behaviour (prolonged sitting) are major risk factors for insulin resistance. When you consume high-calorie foods with bare minimum physical activity, there is a high incidence of weight gain which accentuates overweight or obesity. 

What’s your next step? 

Let’s consider a scenario where you have obesity and experience frequent hunger pangs. You get your tests done and it indicates you have insulin resistance and are prediabetic too. 

What is the next step forward? How do you correct this disorder? Can it be reversed for good? You’re now confused about whom to approach for advice and treatment plan for the same. Right? 

What you need is a team involving a Doctor, Nutritionist and Fitness expert! This is a multi-factorial disorder and you need an entire team that assists you with different aspects of health. 

The conventional doctor’s approach!

According to the conventional approach, an endocrinologist suggests oral medications such as metformin and glimepiride to patients with elevated fasting glucose and lowered insulin sensitivity. They instruct the patient to lose weight and recommend a restrictive diet for the same. 

But, does this actually work? No! You can never lose weight by starving and consuming low-calorie diets. You eventually end up gaining more weight than you lost. What you need to do is lose weight and get medically fit. This is known as medical weight loss. 

Roadmap to reversing Insulin resistance

You can achieve medical weight loss with the help of a team of experts. Your metabolic health doctor understands the disease severity and its underlying reason. You are then referred to a nutritionist who takes you through the importance of consuming wholesome meals with good sources of beneficial fatty acids like omega 3 and omega 6, protein and complex carbohydrates. Once your diet plan is set, the role of a fitness expert comes into the picture. You will be guided and recommended a simple home exercise regime that’ll boost your energy levels and stabilise your metabolism. 

If you thought insulin resistance is your new way of life, you’re absolutely wrong!

You can definitely reverse insulin resistance and increase the sensitivity of insulin by the body by religiously following the plan of action given by your team of experts. 

You will need regular follow-ups with your nutritionist and fitness expert to check your adherence and compliance to the prescribed diet and exercise regime.

Here are some tips to guide you on your journey of reversing insulin resistance,

  • Never skip your meals or swap them with an unhealthy snack option. This only increases your incidence of hunger pangs and you end up eating more and still feeling empty. 
  • Take a stroll in your backyard or a park near you to refresh from the day’s stress. A peaceful walk (hyperlink to the article on benefits of walking) has more benefits than you can fathom! 
  • Exercise for 30 minutes for it helps in increasing your metabolism, thereby increasing insulin sensitivity.
  • Enrol yourself on a weight loss program to lose excess fat and increase muscle weight. This will reduce the incidence of insulin resistance by the cells.
  • Get adequate sleep and maintain your circadian rhythm (body clock). A quality sleep significantly reduces your postprandial blood glucose level and thus, contributes to a decline in insulin resistance.  

Do you think you have insulin resistance? Do you need assistance with losing weight? 

At MediFit, we have successfully reversed insulin resistance and achieved normalised blood glucose levels, and attained favourable weight with a reduction in the disease symptoms. Click here (hyperlink) to get in touch with our team!

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