Insulin Resistance Treatment

Insulin resistance is also known as “syndrome X”.  It affects more than 80 million people in the US. While most people don’t know they have the condition, some people with insulin resistance have symptoms of increased hunger, weight fain, and fatigue. Increased frequency of urination and having to get up at night to urinate are common symptoms of insulin resistance as well.

Insulin resistance is also sometimes referred to as “prediabetes”.  This is because insulin resistance is a precursor illness to eventually develop type 2 diabetes.  Many people with prediabetes don’t know they have it until the disease progresses to type 2 diabetes and they begin to have symptoms similar to those noted above.

People with insulin resistance have an increased risk of more conditions besides diabetes.  Insulin resistance can lead to truncal obesity (where the fat is located more around the waist), high blood pressure, breast cancer, elevated cholesterol levels, and PCOS (polycystic ovarian syndrome, which is a disease where there many cysts on the ovaries that can affect fertility and can cause increased hair growth, infertility, obesity, and acne).

Because insulin resistance can lead to so many diseases, including diabetes, it is often screened for at doctor’s offices throughout the country.  There is no direct test for insulin resistance. The only way it can be identified is through having a morning blood glucose level drawn, which, in insulin resistance, is often elevated.

People with insulin resistance in the early stages may have normal blood glucose levels; however, as the disease progresses, the blood glucose levels can become elevated in the range of 100 mg/dL to 125 mg/dL, which is the definition of prediabetes. Blood sugar levels (fasting) of greater than 125 mg/dL indicated that the insulin resistance has become so severe that type 2 diabetes has developed.

Treatment of Insulin Resistance

As mentioned, insulin resistance is a condition where the insulin levels of the body are elevated but the cells don’t respond to the insulin so glucose cannot be put in the cells of the body and the cells are starved of fuel needed for cellular metabolism.  Treatment of insulin resistance is directed at reversing this process so that the cells are able to use glucose (taken in by eating carbohydrates) can be used as fuel to power the metabolism of the cells.

Under normal circumstances, the body works by balancing the food we digest, monitors blood glucose levels, releases insulin to reduce the blood glucose levels, and uses the glucose to meet the metabolic demands of the cells.  If this doesn’t happen properly, because of insulin resistance, the glucose levels in the bloodstream are elevated and insulin fails to do its job.

No one knows what causes insulin resistance to develop but it appears to be more common among people who are overweight.  Being overweight is one of the main reasons a person develops type 2 diabetes, which is caused by insulin resistance.

Causes of Insulin Resistance

The incidence of insulin resistance is extremely high, affecting about 30 percent or a third of all Americans.  Things that contribute to insulin resistance include the following:

• Having increased truncal obesity (thickness of the waist caused by fat around the midsection)
• Acanthosis nigricans (dark patches of skin around the neck, armpits, knuckles, elbows, and knees)
• Elevated cholesterol and triglyceride levels
• Heart disease
• Gestational diabetes (diabetes occurring only in pregnancy)
• High blood pressure
• Family history of type 2 diabetes (particularly in first degree relatives, such as a parent, sibling, or child)

Even if a person doesn’t have the above conditions as causes of insulin resistance, it is possible to become insulin resistant because of diet alone.  Things like eating processed foods, simple carbohydrates (like table sugar), bagels, white bread, soda, sweets, pasta, and white rice, can contribute to developing insulin resistance.

Processed foods and those foods listed above need more insulin in order to have them be metabolized and this puts more stress on the pancreas to put out insulin in order to get rid of the high blood glucose levels that occur as a result of eating these types of foods. Insulin resistance also tends to worsen with age, regardless of how much we weigh.

Insulin Resistance and Menopause

Women in menopause have an increased risk of many types of metabolic conditions, including insulin resistance, thyroid disease, and problems with the adrenal glands.  As insulin is a common hormone in the body, insulin resistance can result in a lack of balance of other hormones, such as testosterone, progesterone, and estrogen.  When these are unbalanced, it sets up a feedback cycle that worsens insulin resistance.

Many of the symptoms found in menopause (such as hot flashes, night sweats, and insomnia) can be controlled by managing insulin resistance.  Women in menopause have symptoms similar to those seen in insulin resistance, particularly tiredness, increased frequency of urination, mood swings, and insomnia.

One of the biggest problems in menopause is gaining weight.  Insulin resistance worsens this process by disrupting glucose metabolism, causing the excess glucose in the bloodstream to turn into fat.  Because fat cells cannot absorb glucose, a vicious cycle begins to occur, in which the woman in menopause becomes tired and uses carbohydrates to try and build up energy stores.

Fat cells are not only lacking in energy when there is insulin resistance, but they also make too much estrogen, which causes estrogen dominance.  Estrogen dominance is responsible for many of the typical symptoms seen in menopause and in the years just before menopause.

When estrogen levels are decreased in menopause, there is more inflammation in the body and digestive issues come into play. The overall health of the woman is affected and much of the deterioration in health is due to having insulin resistance in menopause.

Controlling Insulin Resistance

Insulin resistance can be treated with or without the use of medications.  Some people with insulin resistance take Glucophage (metformin), which is commonly used drug in both prediabetes and diabetes.  Glucophage is sometimes used when the person is in the early stages of insulin resistance so that the disease doesn’t go on to becoming type 2 diabetes.

Those who want to naturally improve insulin resistance can follow these simple dietary recommendations:

• Eat three moderate meals per day, including breakfast, lunch, and dinner. Supplement the meals with a couple of snacks during the day.  Each meal you eat should have a balanced amount of no more than 15 grams of carbohydrates, lean protein, and small amounts of healthy fats.  The carbohydrates should be complex carbohydrates, such as is seen in fruits and vegetables.
• Eat a diet high in protein (found in lean meats) and high fiber carbohydrates, such as is seen in fresh vegetables, leafy green vegetables, high fiber foods, legumes, whole fruits, and whole grains. Avoid eating highly processed foods that are high in salt and sugar. This should instead involve eating foods that are high in protein, which don’t contribute to insulin resistance.
• Eat foods high in essential fatty acid or other fats as this can help control insulin resistance. You can find healthy fats by eating cold water fish, such as salmon, sardines, and tuna.  If you don’t like fish, you can take a fish oil supplement, or get healthy fats through eating flaxseeds, avocadoes, and eggs.
• Eat snacks that have less than seven grams of complex carbohydrates and virtually no simple carbohydrates (sugar). Try to get fiber in your snacks, which can be found in whole fruits and vegetables.
• Try consuming a nutritional supplement drink that can reduce carbohydrate levels and cravings for sugar. Such beverages can also help keep the hormones be more balances in menopause so that insulin resistance can be improved.
• Exercise can also reduce insulin resistance and can help maintain the balance of hormones in the body. Exercise can also decrease stress levels and should be done about 150 minutes per week for maximum effectiveness.
• Have good lifestyle habits, such as getting at least 7-8 hours of sleep per night, quitting smoking, and drinking alcohol in moderation. These things can help your overall health and can reduce insulin resistance.

Whether you choose to treat insulin resistance by taking medications or by changing your diet and lifestyle habits, the important thing is to treat the insulin resistance as early as possible so as to avoid the complications of insulin resistance, such as the development of type 2 diabetes and its complications.

References:

1. Insulin Resistance? What it is and how we can heal. https://www.womentowomen.com/insulin-resistance/insulin-resistance-what-is-it-and-how-we-can-heal/. Accessed 5/31/16.