What is insulin resistance, how does it affect your body and how is it treated?
Such has been the growth rate of metabolic diseases that they’re now amongst the most significant in affecting the world’s population. The most well known is probably Type 2 diabetes brought on, it is believed, by obesity or increased fat accumulation.
One of the factors in the development of Type 2 diabetes is insulin resistance which is a decreased sensitivity to insulin in tissues which are insulin receptive.
Some research suggests that insulin resistance comes about because of a rise in what’s called oxidative stress which is an imbalance in the production of free radicals and the body’s ability to control their harmful effects. This appears to come about as the result of a high calorie diet and the build-up of fat tissue.
However, some people appear to have an inherited genetic disposition to IR due to a small variation in hormone receptor sensitivity.
Insulin, which is produced by the pancreas, helps to unlock your body’s cells so that the sugar in food we consume is converted to energy. Unfortunately once you are insulin resistant there are several effects on your body:
- Your blood cells can no longer efficiently process insulin which means you lack energy
- The pancreas works overtime to produce more insulin because the body’s cells are resistant to the effect of insulin
- Under the influence of more insulin your body receives instructions to “gain fat”. In response, you feel hungry and compelled to eat more.
- If that doesn’t work the body will decrease energy expenditure so that it can gain weight
It’s important to realise that 3 and 4 are not voluntary acts. This is perhaps not as surprising as it may first appear - hormones tell us we’re hungry and they tell us when we’re full. They tell us when to increase our energy expenditure and when to shut it down.
Signs and Symptoms
Unfortunately those with IR will now have a major battle on their hands as they’re likely to feel physically exhausted (so not inclined to exercise); hungry, battling with “brain fog” and struggling with a significant gain in weight.
They may still not realise that they are insulin resistant as there are hardly any other noticeable symptoms except – in some people - dark patches on the neck, armpit or groin areas known as acanthosis nigricans and small skin tags.
However, here is now strong evidence that an increasing waist circumference is the first sign that you are developing insulin resistance. The waist circumference is measured around the abdomen at the level of the belly button (umbilicus) and reflects the fat that collects inside the abdomen around the gut.
European men are defined as being centrally obese once their weight circumference is above 37 inches (94cm) and their risk of diabetes is significantly raised once their waist circumference is greater than 40 inches (102cm). The equivalent figures for women are 31.5inches (80cm) and 34.5inches (88cm).
The presence of these signs plus the results of a borderline raised blood glucose test (pre-diabetes) will be indicators of the condition which is also associated with an increased risk of hardening of the arteries, fatty liver and reproductive abnormalities in women.
IR can also lead to type 2 diabetes as the overworking pancreas can no longer produce enough insulin for the body’s needs and this results in a rise of blood sugars overall.
Treatment
Whilst genetic factors may come into play it is possible to reduce the effect of insulin resistance by
- Following low carbohydrate and ketogenic diets (a very low carbohydrate diet of less than 30g carbohydrates daily) and dominating your diet with protein and vegetables
- Taking a lot of exercise
- Bariatric intervention which will change the metabolism where weight gain has become intractable despite major dietary and exercise interventions.
Bariatric surgery will only be available on the NHS if there are significant health consequences caused by the weight gain, but it is possible to get finance on private operations which are likely to be in the region of £5k to £8k. However the first step, if this blog post makes you believe you may have IR, is to go to your GP.
I do hope this has been helpful.
Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.
As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link.
