Understanding Insulin and Insulin Resistance

There is an epidemic of obesity and type 2 diabetes that is spreading not just through the USA and other western countries, but all around the world. According to the CDC, 1 in 10 Americans have been diagnosed with type 2 diabetes. 

While it’s often seen as a condition affecting older people, the more worrying statistic is that we’re starting to see greater incidence of type 2 diabetes in children and young adults. One of the main factors related to the development of type 2 diabetes is insulin resistance. 

Here we take a look at what this is, why it happens and how insulin resistance progresses and develops into a disease like type 2 diabetes.

What is Insulin?

When we eat, our blood sugar levels rise. In response to this and to maintain normal healthy levels in the body, the pancreas releases a hormone called insulin. 

This essentially ensures that glucose levels in the blood are moved into areas like the muscles, fat and liver where they are stored. When we exercise or we’re fasting, this store can be drawn on to provide energy.

What is Insulin Resistance?

When cells stop responding to insulin, this is known as insulin resistance. This means that the muscles, fat and liver don’t store the glucose and it remains in the bloodstream. In response, the pancreas tries to produce more insulin. 

This can have a cyclical effect if left unchecked and can eventually lead to permanently raised insulin and glucose levels in the blood as well as damage to the pancreas. 

When an individual has developed insulin resistance and their blood sugar reaches a certain point, they are diagnosed with type 2 diabetes.

Insulin Resistance vs. Insulin Sensitivity

Insulin sensitivity relates to how our bodies react to levels of blood sugar. The level of sensitivity is extremely important in maintaining the right balance for optimal health – if there is too much blood sugar, more insulin is produced. 

As the body becomes less sensitive, insulin resistance can develop, making it more difficult for cells and organs to store glucose.

Doctor measuring the waist of a patient

What Causes Insulin Resistance?

There are several factors that can contribute to the development of insulin resistance, although the exact mechanism is still not fully understood. 

  • Increased levels of fat and fatty acids in the blood, normally because someone is overeating or eating the wrong diet is an important contributory factor. 
  • Developing visceral fat in the abdominal area is a sign that someone is at greater risk of developing both insulin resistance and type 2 diabetes. 
  • Other factors include lack of exercise, high fructose intake through processed sugar, and oxidative stress caused by inflammation.

Symptoms of Insulin Resistance

There are a number of symptoms associated with insulin resistance in its early stages. Those affected may be carrying excess weight around the gut (more than 40 inches for men and 35 inches for women) and have high blood pressure. They may also exhibit a skin condition called acanthosis nigricans where dark spots or skin tags are present. 

Diagnosis and Tests for Insulin Resistance

blood test is usually performed to reveal blood sugar and insulin levels. If someone has been fasting and insulin levels are still high, for example, this is a pretty good indicator of resistance. Low HDL cholesterol and high levels of triglycerides in the blood are also important markers. 

The main tests for blood sugar levels are:

  • Fasting blood glucose test
  • Oral glucose tolerance test
  • Hemoglobin A1c test

How Insulin Resistance Progresses to Type 2 Diabetes

Just because someone is insulin resistant does not mean they will necessarily have developed type 2 diabetes. In some cases, insulin resistance for a short time is a natural process and the pancreas producing higher levels of insulin is a normal response. 

If resistance keeps up, however, the pancreas will start to struggle and, over time, will become damaged. Blood sugar levels generally rise until the individual becomes pre-diabetic. A fasting blood glucose level of 100-125, for example, suggests pre-diabetes and insulin resistance. 

Once it reaches above this, they may be diagnosed with type 2 diabetes. This normally happens when the individual in question hasn’t made the right lifestyle changes to help bring their insulin resistance under control.

How to Reverse Insulin Resistance

Insulin resistance when spotted early and before someone is diagnosed with type 2 diabetes is reversible. A conventional medical approach will often use medicines and other interventions to deal with the condition by managing the symptoms.

A personalized and functional  medicine approach takes a different view – looking at the root causes of a particular health issue and helping to combat these directly. In the case of insulin resistance and diabetes, a functional medicine practitioner will look at the patient’s history, family history in relation to this kind of health problem, the diet they maintain and how much physical activity they undertake. 

Personalized medicine offers a holistic approach, and will look to change the patient’s diet, lowering consumption of unhealthy, over processed foods with unnecessarily high levels of refined sugar, for example.