Insulin Resistance

Written By Dr Alison Kamffer



What is it?

Insulin resistanceis a disorder in which the cells of the body become unresponsive to the effects of insulin leading to an increased risk of diabetes and heart disease.


The main cause is a diet rich in refined carbohydrate [sugars], leading to overweight and obesity, which stresses the pancreas to overproduce insulin, resulting in the cells becoming unresponsive to its effects. There is also a genetic factor, as it is more common in those of Indian ancestry, as well as women with Polycystic Ovary Syndrome.


It is often associated with the metabolic syndrome which is characterized by :

· Raised blood fats (blood triglycerides).

· Low HDL (a part of blood cholesterol).

· Type 2 Diabetes ora fasting blood glucose higher than 5.6mmol/l,[‘pre diabetes’ ].

· High blood pressure [treated or not].

· Insulin resistance is diagnosed by testing the blood sugar after a 4 hour fast. Serum insulin, a popular test, is not recommended by specialists as it is both unreliable and superfluous.

Insulin resistance and metabolic syndrome are not the causeof weight gain or obesity, rather a result.


Who gets it?

It becomes more common with increasing BMI and waist measurement. Research has shown that adults who continue to gain a minimum of 2kg in weight per year increase their risk of developing the syndrome by 45%.

Those at greatest risk include people of Indian ethnic origin, who have a genetic tendency to develop the syndrome at much lower BMI than the Black or European population.

Those with close relatives with diabetes.

Women with Polycystic Ovary Syndrome.

Women who became diabetic during pregnancy, or who gave birth to a very heavy baby, [which is usually due to excess glucose in the blood feeding the baby via the placenta].


What are the Causes?

Insulin is the hormone secreted by the Beta cells of the pancreas in response to an increase in blood glucose [sugar]. Insulin stimulates the removal of glucose from the blood into the body’s tissuesfor use as fuel or for storage. In insulin resistance, the tissues do not respond readily to the instruction from insulin to remove the glucose from the blood, with the result that the pancreas puts out increasing amounts of insulin to try to keep blood glucose levels normal. Eventually it can no longer maintain normal blood glucose, and the levels start to rise, despite high levels of insulin. This is known as impaired glucose tolerance or‘pre diabetes’. In time the blood glucose reaches levels compatible with a diagnosis of Type 2 Diabetes. Later in the disease, the pancreas literally burns out, and produces less and less insulin as the Beta cells die from exhaustion, and patients that at first had high insulin levels in the blood later become insulin deficient, and may need extra insulin by injection. This often occurs after about 10 years.


We can use the illustration of a food delivery lorry [the blood stream]. Under normal circumstances the food will be off loaded into the local supermarket [the body]. If too much food is delivered and not enough purchased from the shop [i.e. used by the body] then the lorry starts to overflow, and as the supermarket fills, there is eventually no more space and the food is left in the delivery lorry. In the same way, if a person overeats they store the extra as fat, and the body tries not to store more so leaves the excess sugar in the blood stream.


What is the usual Treatment?

The most important treatment is weight control. Even the loss of just 5- 10% of body weight can reduce the risks considerably. A healthy dietshould consist of no more than 50% carbohydrates [starches] which should be as natural and unrefinedas possible, such as whole wheat flour, brown rice and plenty of fresh fruit and vegetables. Alternatively, a very low carbohydrate diet, containing no more than 20% starches, can be extremely effective in reducing insulin resistance.


Sugar should be avoided. This includes food and drink containing high amounts of sugar, such as undiluted fruit juices, cool drinks [still or gassy], sweets, cakes, biscuits etc. Learn to read food labels; anything with a name ending in –ose is probably a sugar.

You should increase your intake of fish, chicken and pulses.


Exerciseis very important as it helps maintain healthy blood lipid [fat] and glucose levels, and is psychologically helpful for people who are trying to lose weight.

If weight control and a healthy diet do not reduce the blood glucose levels sufficiently, then patients are given Metformin.This medicine helps the body absorb glucose more efficiently, without causing an excessive drop in blood sugar [hypoglycemia].


What Other treatments are available?

The healthy fats, omega 3, in nuts and fish oilprotect the arteries against the damage caused by raised insulin and glucose levels.

Learn about the Glycemic loadof foods, and eat a low GLdiet

Cinnamonhas been shown to reduce insulin resistance, and several commercial preparations are now available at health shops and Pharmacies.

Chromium200ug 3 times daily and Gymnestre Sylvestre 200mg 3 times daily both reduce insulin resistance, as do Aloe vera, Garlic, gentian, and goats rue.

Coccinia cordifolia, commonly known as Ivy gourd, is a vegetable grown in India which has been shown to lower blood sugar levels.

The herb Salacia Oblongais believed to control blood glucose and it has an additional benefit of containing weight gain inhibitors.

Bitter gourd or melon(Momordica Charantia) is effective in insulin resistanceboth by increasing glucose intake by the body, and by suppressing the body’s response to the stimuli of sweet tastes.


Long term complications

It is now accepted that this problem is associated with a syndrome,or a group of disorders, which include the following:

Hypertension [High blood pressure]

Hyperlipidemia [high cholesterol]

Diabetes type 2

Athersclerotic heart disease and strokes.

A tendency towards raised uric acid levels, causing gout.

Certain obesity related cancers, particularly lymphomas, breast cancer and bowel cancer.

If not treated, the long term problems associated with diabetes will develop, including kidney, eye and circulation problems.

Premature osteoporosis is being reported in obese adolescents.


WHEN TO WORRY

If you are overweight, especially around your waist, you should see your Doctor, clinic sister or pharmacist, and ask them to check your blood sugar levels. This may be done on a finger prick, or a sample may be sent to the lab which measures your average sugar over the last 3 months[ the Hba1c].

If you have symptoms such as excessive thirst and urination, recurrent skin infections etc get that sugar checked. Treatment may save your life!

Instead of waiting until the damage is done, act now and reduce your weight and start exercising! SureSlim specifically addresses problems of insulin resistance, and offers a choice of a normal 40% carbohydrate redcing program, or a low,20% carbohydrate program .


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