Metabolic Syndrome: The Dangers of Insulin Resistance and its Complications

For many years, treatment of type 2 diabetes focused on lowering blood sugar through medications like insulin, sulfonylureas and metformin. However, large studies have now shown that simply lowering HbA1c does not necessarily improve health outcomes like heart attacks, strokes, kidney failure and death. Why is this?

For many dealing with type 2 diabetes, a lifetime of insulin shots and blood sugar monitoring feels inevitable. But emerging science shows that in some cases, diabetes remission may be possible by addressing its root cause – insulin resistance.

Insulin resistance is the state when cells become less responsive to the effects of insulin, the hormone that allows glucose absorption. This forces the pancreas to overproduce insulin while glucose builds up in the bloodstream. Over time, insulin production declines as cells wear out, leading to high blood sugar and type 2 diabetes.

Reversing Diabetes by Addressing Insulin Resistance

It turns out we were treating the wrong thing. High blood sugar is a symptom of type 2 diabetes, not the underlying cause. The root problem is hyperinsulinemia – having excessive circulating insulin levels over many years due to factors like overeating, refined carbs, weight gain and inactivity.

Insulin is normally a beneficial hormone. But in hyperinsulinemia, chronically high insulin drives fat storage and leads to obesity, fatty liver disease, high triglycerides, low HDL cholesterol and ultimately insulin resistance. This cluster of metabolic abnormalities is called metabolic syndrome and represents the underlying pathology behind type 2 diabetes.

Treating high blood sugar alone ignores these root causes. Just moving glucose from the blood into tissues does not solve the problem when tissues are already overloaded with fat and glucose. Cells resistant to insulin are not truly starved of energy, but rather overfilled due to years of excess energy intake.

How Insulin Resistance Drives Type 2 Diabetes

Newer diabetes medications like SGLT2 inhibitors and GLP-1 agonists provide benefits like weight loss, reduced CVD events and slowed kidney disease progression because they address the underlying hyperinsulinemia. They lower insulin levels rather than just reducing blood sugar.

Weight loss, low-carb diets, exercise and intermittent fasting can also lower insulin and reverse diabetes by addressing the root causes instead of just managing the symptoms.

Insulin resistance can be reduced and even reversed through specific lifestyle interventions like:

• Weight Loss – Losing excess fat, especially visceral belly fat, can significantly improve insulin sensitivity and reduce insulin needs. Even losing 10-15% of body weight can induce remission in some diabetics.
• Exercise – Physical activity, both aerobic and strength training, can help cells better metabolize and store glucose. Exercise also supports weight loss.
• Dietary Changes – Cutting refined carbohydrates and unhealthy fats while increasing fiber slows down glucose absorption and reduces inflammation.
• Certain Medications – Metformin, alpha lipoic acid and chromium have been shown to improve insulin performance.
• Intermittent Fasting – Periodic fasting gives cells a break from high insulin and has been shown to reverse insulin resistance.

Why Insulin Resistance Matters in Diabetes Treatment

In contrast, insulin, sulfonylureas and even older generation drugs like metformin tend to worsen outcomes. They spur insulin secretion and weight gain, exacerbating rather than fixing the high insulin levels that lie at the heart of type 2 diabetes.

The bottom line is insulin resistance and metabolic health must be addressed to achieve lasting reversal of type 2 diabetes. By implementing proven lifestyle strategies that support the body’s insulin pathways, remission of diabetes may be within reach.

Effective treatment requires addressing the underlying insulin dysfunction and overnutrition rather than myopically focusing on short-term blood sugar reduction.