Understanding and Reversing Insulin Resistance

Insulin resistance is a growing health concern around the world. It is the root cause of many chronic diseases and conditions known as the “curse of prosperity”. By understanding what insulin resistance is, what causes it, and how to reverse it, we can take control of our metabolic health.

What is Insulin Resistance?

Insulin is a hormone produced by the pancreas that allows cells throughout the body to absorb and utilize glucose from the bloodstream. It “unlocks” cells, allowing glucose to enter.

Insulin resistance refers to cells becoming less sensitive and responsive to the effects of insulin over time. As a result, higher levels of insulin are needed to achieve the same effects. The common signs of insulin resistance include:

• Elevated insulin levels in the blood (hyperinsulinemia)
• Normal blood glucose levels
• Increased waist circumference
• Skin tags or dark patches on skin folds
• Family history of diabetes or metabolic conditions

Insulin resistance itself does not cause noticeable symptoms at first. Over many years, it can progress to type 2 diabetes as the pancreas struggles to produce enough insulin to overcome resistance. High blood sugar becomes the obvious symptom.

However, the root of the issue – insulin resistance – has been developing for a long time before this point. Looking solely at blood glucose as an indicator of metabolic health misses this. Insulin resistance causes damage to the body’s tissues silently for years through chronic hyperinsulinemia.

Causes of Insulin Resistance

The primary drivers of insulin resistance are:

1. Chronic Stress

Both physical and emotional stress cause the release of hormones like cortisol that shift metabolism into a pro-inflammatory state. This directly interferes with the sensitivity of insulin receptors on cells throughout the body.

2. Inflammation

Systemic, low-grade inflammation is closely tied to insulin resistance development. Inflammatory signaling molecules can downregulate key proteins involved in the insulin signaling cascade within cells.

3. Hyperinsulinemia

Excessively high insulin levels cause cells to become less responsive to its effects over time, similar to building tolerance. This creates a self-perpetuating cycle. The resulting insulin resistance provokes even higher insulin secretion, which drives more resistance.

Diet plays a major role in this cycle. Foods that spike blood glucose and stimulate large amounts of insulin secretion multiple times a day keep insulin elevated. Over time, cells protect themselves by resisting insulin’s effects.

Health Consequences of Insulin Resistance

Insulin resistance is the gateway to a myriad of chronic diseases:

• Heart disease
• Type 2 diabetes
• Certain cancers like breast and colon
• Fatty liver disease
• Infertility and PCOS
• Alzheimer’s and dementia
• Stroke

The common factor is chronic hyperinsulinemia. Insulin is not just involved in blood sugar control. It is a growth-promoting, pro-inflammatory hormone when chronically elevated.

For example, insulin promotes fat production and storage in the liver, driving fatty liver disease. It also accelerates growth and proliferation of cancer cells when elevated.

Recognizing hyperinsulinemia as the root issue is key to preventing and addressing these associated health conditions.

Reversing Insulin Resistance Through Lifestyle

Type 2 diabetes used to be referred to as “adult-onset diabetes” because it generally developed later in life. However, with rising rates of obesity and poor metabolic health, it is now occurring earlier in adulthood and even childhood.

Lifestyle changes are extremely effective at reversing insulin resistance before it progresses to diabetes, especially when implemented early. Medications only treat the symptoms, not the root causes.

Step 1: Reduce Carbohydrate Intake

Carbohydrates, especially refined grains, sugar, and starchy foods, are the main driver of elevated insulin when consumed in excess.

Reducing overall carbohydrate intake and focusing on fibrous vegetables lowers insulin demand on the body. High fiber foods help slow glucose absorption and insulin secretion.

Step 2: Prioritize Protein at Meals

Protein foods like meat, fish, eggs, and dairy have a mild impact on insulin compared to carbohydrates. Ensuring sufficient protein at each meal helps sustain energy levels and avoid overeating carbs.

Step 3: Include Healthy Fats

Despite outdated advice to avoid fat, healthy fats are essential and do not negatively impact insulin. In fact, eating fat with protein improves absorption of the protein and provides lasting satiety. Excellent choices are olive oil, nuts, avocado, and fatty fish.

Step 4: Exercise and Manage Stress

Exercise directly improves insulin sensitivity in muscles. Any form of activity helps, but resistance training is especially effective. Managing emotional stress through meditation, yoga, journaling, etc. also lowers insulin resistance by reducing inflammation.

Measuring Insulin Resistance

Rather than solely monitoring blood glucose, measurements related to insulin give a better picture of metabolic health:

Insulin Levels – Fasting insulin should be in the range of 5-15 ?IU/mL. Levels above 15 indicate growing insulin resistance.

HOMA-IR – This calculation uses fasting glucose and fasting insulin. Scores above 1.5 suggest insulin resistance.

HbA1c – This reflects average blood glucose over 2-3 months. Goal is under 5.7%. Between 5.7-6.4% indicates prediabetes.

Triglycerides – Ideal is under 150 mg/dL. Levels over 200 mg/dL suggest insulin resistance.

Waist Circumference – Fat stored around the abdomen strongly correlates with insulin resistance. Keep this measure under 40 inches for men and 35 inches for women.

Tracking these markers, in addition to glucose, provides a more complete picture of metabolic health and whether lifestyle changes are working to reverse insulin resistance.

Insulin Resistance Can Progress Over Years Into Type 2 Diabetes

Left unchecked, insulin resistance can progress over years into type 2 diabetes and other chronic diseases. The root causes are hyperinsulinemia along with inflammation and stress.

Lifestyle changes focused on improving diet, managing stress, and increasing activity can all help reverse this process by restoring insulin sensitivity. Getting your insulin levels checked regularly and implementing lifestyle changes early provides the best opportunity for prevention and recovery.