Firstly, what is insulin?
Insulin is a hormone that is produced by the beta cells in the pancreas and plays a vital role in regulating blood sugar levels. When we consume carbohydrate foods – for example, fruit, starchy vegetables, breads, rice, pasta, milk, etc. – it travels to the stomach where it is broken down. From there, glucose (sugar) is released in our bloodstream, which then signals our pancreas to release a hormone called Insulin. Insulin’s role is then to help move the sugar from our bloodstream into our cells (e.g our muscles and liver) to be used for energy (,,).
What is insulin resistance?
Insulin resistance occurs when the cells in the body don’t respond well to the effects of Insulin. Put simply, this means that a normal amount of insulin secreted by the pancreas is not enough to manage the levels of sugar in the bloodstream. As a result, the pancreas releases more insulin in an effort to lower blood sugar levels (,,,). While this may work to lower blood sugar levels for a while, the pancreas struggles to keep up with the demand of extra insulin. Over time, this causes blood sugar levels to rise which increases the likelihood of pre-diabetes and type 2 diabetes (,,,).
What causes insulin resistance?
While the exact cause of insulin resistance is not completely understood, there are several genetic and lifestyle factors that can increase the risk, for example:
- A family history of type 2 diabetes
- Gestational diabetes
- Medical conditions such as Polycystic Ovarian Syndrome (PCOS), Cushing’s Syndrome, and Non-alcoholic fatty liver disease
- Certain medications e.g. steroids, some psychiatric medications, and HIV medications
- Age – being >45 years old increases the risk
- Ethnicity e.g. those from pacific islander, Asian-American, African-American descent have a higher chance of developing insulin resistance
- Having high cholesterol or high blood pressure
- Being overweight and carrying excess weight around the midsection
- Having a sedentary lifestyle with little to no movement
- A diet high in refined carbohydrates, high-fat foods, and processed foods
- Sleep issues such as sleep apnea (,,)
What are the signs of insulin resistance?
While most people don’t have symptoms or show signs of insulin resistance, there are some that may indicate the condition such as:
- Fatigue – as the body is not converting glucose into energy efficiently, this can be a common sign of insulin resistance
- Sugar cravings – this may occur due to fluctuating sugar and insulin levels across the day
- Weight gain around the midsection
- Difficulty losing weight despite regular exercise and dietary changes
Skin conditions – skin tags or Acanthosis Nigricans – a skin pigmentation condition that appears as dark patches under the armpits, on the groin and on the back of the neck are common with insulin resistance (,,).
How is insulin resistance diagnosed?
If your doctor suspects you have insulin resistance, there are several blood tests they may choose to look at to diagnose the condition, for example:
- Glucose levels – This can be to look at fasting blood glucose levels, or they may also choose to do an Oral Glucose Tolerance Test (OGTT). This measures your body’s response to glucose by checking your fasting blood sugar levels, then your sugar levels one and two hours after consuming a sweet drink containing 75g of glucose ()
- HbA1C – this test reflects your average blood glucose levels over the last 3 months by measuring the amount of haemoglobin that’s bound with glucose in the bloodstream ()
- Insulin levels – fasting insulin levels may be tested in addition to insulin levels one and two hours after consuming glucose as part of an Oral Glucose Tolerance test ()
Lipid profile – your doctor may also want to measure your total cholesterol, HDL and LDL levels, and triglycerides levels ()
Can insulin resistance be prevented?
While certain risk factors such as family history or age cannot be changed, there are many lifestyle changes you can make to reduce your chances of insulin resistance and developing type 2 diabetes (,,,,).
Regular movement – physical activity has been found to improve insulin sensitivity and is one of the best ways to prevent insulin resistance
A healthy eating plan – adopting a balanced diet that contains fresh, unprocessed foods and limits refined foods, high-fat foods, and added sugars is also one of the best ways to prevent insulin resistance. It’s also important to avoid eating large amounts of carbohydrates as this will stimulate excess insulin to be produced. Seeking individualised support from an Accredited Practising Dietitian can be a great option to help you find the diet balance according to your lifestyle
Losing excess fat mass – losing weight, particularly around the mid-section is a well-known method to prevent insulin resistance
Improving sleep quality and duration of 7-9 hours a night
Medications such as metformin may also be prescribed by your General Practitioner to help manage insulin resistance (,,,,)
The take-home message
While insulin resistance is a complex condition that can increase the risk of type 2 diabetes, there are many lifestyle measures you can take to prevent the condition altogether which include regular movement and adopting a healthy eating plan.
Seeking individualised support from an Accredited Practising Dietitian can be a great way to help prevent insulin resistance and to improve your overall health. Book your free assessment to learn more about our programs at Diabetes Wellness Australia and to speak to one of our friendly staff today.