Understanding Insulin Resistance
Insulin resistance is a normal part of human biology. Cells can be resistant to the effects of insulin for many reasons, some of which are actually helpful! But chronic insulin resistance can have negative impacts on health. What is this condition and what can we do about it? Read on…
What is Insulin Resistance?
Insulin is a hormone your body needs to move glucose from the blood stream into the muscle and adipose tissue to be used as fuel (ATP).
In insulin resistance, the cells struggle to recognize and respond to the hormone. As a result, glucose doesn’t move into the cells where it belongs.
This causes glucose to stay in the blood stream longer – so levels get higher. And the pancreas produces more insulin to try to feed the cells.
Fun fact: Only insulin lowers blood glucose. But MANY others raise glucose in our body (epinephrine, cortisol, growth hormone, glucagon)
What Causes Insulin Resistance?
The following are circumstances in which insulin resistance is more common:
- Excess glucocorticoids (Cushing’s syndrome, steroid therapy, extreme stress).
- Excess catecholamines
- Excess growth hormone (acromegaly)
- Polycystic ovarian syndrome
- Lipodystrophy (acquired or genetic, associated with lipid accumulation in the liver)
- Autoantibodies to the insulin receptor
- Mutations of insulin receptor
- Mutations of the peroxisome proliferators’ activated receptor y (PPAR y)
- Mutations that cause genetic obesity (eg, melanocortin receptor)
- Visceral adiposity
- Hemochromatosis
- Inadequate intake
- Certain medications (eg, steroids, atypical antipsychotics, statins)
- Tobacco use
- Alcohol use
- Aging (eg, declines in estrogen; loss of lean tissue; reduced activity)
- Puberty
- Pregnancy
What’s the Problem?
First off, just because something increases insulin resistance does NOT mean you have diabetes! There are many theories and correlations, but no certainty in what actually leads to the development of type 2 diabetes in which insulin resistance is chronic.
But chronic insulin resistance is not the goal as it can have a lot of down stream effects, especially if the liver is resistant to insulin.
These include increased insulin production, stress on the pancreas, weight gain, and changes in how the liver repackages lipid molecules.
What Can You Do?
Here’s where it gets tricky. Most commonly, folks are told to lose weight regardless of their current weight.
While insulin resistance is more common for folks with increased adipose deposits within muscles and around organs, that does not necessarily mean their size is what’s causing the insulin resistance.
As you can see from the above, there are MANY factors that impact insulin resistance that go beyond weight. Many of which we do not routinely test for nor do we always have control over.
Rather, it’s importance to consider what we can can help the body be more sensitive to insulin, thereby reducing the insulin resistance.
Reduce Insulin Resistance
Increase muscle tissue with strength training. This helps create more glucose receptors.
Use your muscles more often. Bonus if you get your heart rate up at times, but all movement helps the body and/or the mind. This helps clear excess glucose and sensitizes the receptors.
Understand psychological stressors – learning how to work with your system to regulate emotions. This helps reduce stress hormones that increase IR. It can also reduce harmful behaviors that increase IR like alcohol and nicotine.
Understand physiological stressors – exploring sleep quality / quantity, dietary adequacy, dietary frequency, dietary and options for anti-inflammatory foods. Some of these reduce stress hormones and others make the glucose load more manageable.
What About Weight?
It’s tempting to make insulin resistance about weight. But here’s the thing, many weight loss practices are unsustainable and may increase insulin resistance in the long term (eg, not eating enough, long durations between eating, excessive exercise, inadequate rest, loss of lean tissue).
Moreover, too often I’ve had folks stop engaging in health behaviors that we know benefit insulin resistance simply because the scale didn’t change fast enough.
It’s important to commit to the behavior, not obsess over the scale. The behavior does not need to be rigid, obsessive, fear or shame based. But instead coming a place of curiosity – to learn and problem solve.
I’m not saying you “can’t” lose weight, but I do encourage folks to explore beyond the scale to understand and support themselves.