You may have heard of insulin resistance, but has anyone taken the time to explain what it is? 

Often, we only think of blood sugar and insulin in the case of diabetes. But blood sugar and insulin have an important function in everyone’s body.

Did you know that if you are struggling with insulin resistance, it can make it REALLY EASY to gain weight and REALLY DIFFICULT to lose it (regardless of how much you are eating?!)

Let's look at this important process so we understand what is going on in our bodies and can make wise choices surrounding blood sugar and insulin.  

The Connection Between Blood Sugar and Insulin

Our body functions best when our blood sugar is just under 100 (75-99). It will work to stay around that range by releasing the hormone insulin. 

Insulin is what helps the sugar to go from our blood into our cells (Specifically liver, muscle, and fat cells). Pretend that our cells have doors on them, and the insulin is the key that opens those doors, allowing the sugar to go through the door into the cell.

When we eat food, especially carbohydrates, our blood sugar goes up. Our brain recognizes that there is too much sugar in the blood, so it releases insulin.

If the body is working at an optimal level, the insulin acts like a key and begins to open the cell's doors. The sugar is able to get in the cell, the blood sugar goes back to a comfortable level, and the sugar is stored in the cell for future use.

There is a nice cycle of getting hungry, signaling that your body needs sugar. Feeling full when your body gets the sugar into the cells. Feeling hungry when the body needs more sugar and so on.

When the Keys Don’t Work Well

If you have insulin resistance however, the insulin doesn’t work very well. It’s like the keys aren’t working. It may take 2-4 hours to open the doors when it should just take an hour.

When the brain notices the sugar is still in the blood and not in the cells, it decides it needs to do something about it. That’s when the brain tells the body to release more insulin and this results in an unhealthy level of insulin circulating through the body.

What actually causes Insulin Resistance? Here are just a few of the many possibilities

• Genetic Predisposition 
• Vitamin and mineral deficiencies (Vitamin D and B12 to name a few)
• Toxic exposure (BPA in plastics and Agent Orange exposure are just 2 examples, but there are likely thousands)
• Having chronically elevated blood sugar

As you all should know by now, I love to relate everything to our ancestors. When we are looking at our ancestors through a lens of insulin resistance, there were certain times that it was actually beneficial to be more insulin resistant. Think about the seasons for example. When would our ancestors have eaten higher amounts of fruit/sugary substances? This would happen in the late summer as fruits are reaching their peak ripeness. Eating higher amounts of sugar (especially fructose in fruits) signaled to their bodies that it was time to start preparing for winter by putting on some body fat. This process allowed our ancestors to survive a winter when food was more scarce. Unfortunately for us, we constantly have access to high fructose/sugar foods, and almost never have a time that food is scarce. This is probably the most likely contributing factor to the fact that 88% of our population is not in ideal metabolic health. 

 

 

The Problem with High Insulin

I talk to patients every day who want to  lose weight, but are struggling to do so. They are often times already eating a "low calorie" diet, and still not losing the weight they feel that they should be. One of the most common reasons for this is that their insulin might be too high. Insulin is a STORAGE hormone. It helps you take sugar and store it. When Insulin is chronically too high, the body is always in storage mode. Good like trying to burn your own fat stores while you are in storage mode. 

There was a study done back in 1992 that illustrates this point beautifully. The subjects in the study were injected with insulin to control their type II diabetes. The study was 6 months long. It was noticed after a few months that the weight of the participants was going up. They were recommended to eat less calories. From the beginning of the study, calorie intake decreased from 1937 to 1711, yet the participants GAINED an average 19 pounds!!! That's right, they ATE LESS and GAINED WEIGHT. For anyone who has ever been told that weight loss is a simple calorie in, calorie out equation, I hope your mind is blown right now. The was a direct correlation with the amount of insulin that patients injected and how much weight they gained. 

Even if you aren't injecting insulin, if your body is chronically having higher than ideal insulin levels, weight gain or difficult weight loss can definitely be a symptom. 

Signs of Being Insulin Resistant

There are many signs that you may have insulin resistance. If you have many of the following symptoms may benefit from being intentional about controlling your blood sugar.

• Craving sugar/sweets
• Being irritable if meals are missed
• Getting a light headache if meals are missed
• Feeling tired after eating
• Eating sweets does not relieve my cravings for sugar
• Needing something sweet after a meal
• Your waist circumference is equal or larger than my hip circumference
• Urinating frequently
• Having an increased thirst and appetite
• Lab work that shows elevated blood glucose, HbA1C, or insulin

I wanted to add a quick note about Lab work. If your fasting blood glucose, HbA1C or insulin are trending high, that could be a sign that you are experiencing insulin resistance. Fasting Insulin will typically be the FIRST marker to trend high, yet most doctors don't test for this. Because the body can pump out more insulin for YEARS before blood sugar markers actually increase, you could have higher than ideal insulin for years while HbA1C and fasting blood glucose are actually still showing "within normal range". 

Additionally, that HbA1C marker is great to show an average of how high your blood sugar was over the past 3 months, but it is on a spectrum. The lab won't flag HBA1C as high until 5.7%, so there are many of us hanging out at 5.4-5.6% thinking that we are doing great. While these numbers don't signify prediabetes YET, in my mind, they are higher than ideal, and I encourage patients that see anything higher than 5.2-5.3% to take that as a sign to inspire them to make some changes in their diet and lifestyle as opposed to watching and waiting for them to creep higher. 

What You Can Do About It

1) If you suspect you may be insulin resistant, it is important to pay attention to what you eat. It is often helpful to limit your sugar intake, and pair carbohydrates with a protein, fat, and fiber (vegetables).

This may mean changing your breakfast cereal for eggs or adding nut butter to your oatmeal. You may want to have some nuts with fruit for a snack. If you don’t have time to have a full meal, choose to eat a protein and fat rather than a meal full of carbohydrates.

2) Reducing quick sugars can make a HUGE impact. Cutting out sugary beverages like soda, juice, sweetened coffee drinks is a great step. Additionally, 60% of processed foods have fructose in them (think high fructose corn syrup), and these foods have an especially damaging impact on our metabolic pathways. 

3) Getting good sleep can have a huge impact on our insulin sensitivity. Prioritizing at least 7-9 hours of sleep every night can make a huge difference in how our body handles our blood sugar and insulin. If you sleep well, you will have more energy to eat those healthy protein + fat + fiber meals as opposed to reaching for sugar or a sugar sweetened beverage to help you power through your day. 

4) Moving your body can be hugely helpful! Going for a morning walk or taking a walk after a meal are incredibly helpful for lowering blood sugar and insulin. Additionally, increasing your muscle mass by lifting weight can help cells become more sensitive to insulin and can make it easier from blood sugar to get out of the blood and into the cell. 

5) Reduce your stress levels. I saw a story recently on a women with insulin resistance who was wearing a continuous blood sugar monitor. This is a device that measures your blood sugar 24 hours a day. She decided to do an experiment in which she ate the same foods for 2 consecutive weeks. During the second week, she had a project due at work which added significant stress to her life. When she compared the blood sugar graphs over the 2 weeks, she noticed a big difference. Even though she ate the same, when she was stressed, her highs were higher, and sugar stayed elevated longer after her meals. If you are feeling chronically stressed I encourage you to really look into this and see if you can do something to reduce your stress levels, or add an stress reduction activity like meditation, going for walks, taking a bubble bath, etc. 

A Special Note to Those with PCOS

Insulin resistance is a leading root cause underlying 75-85% of PCOS. And for women with PCOS who struggle with weight gain the percentage is even higher (95%).

If you learn to control your blood sugar and balance your hormones, there is a good chance that your PCOS symptoms will come under control.

You can see a huge difference in your symptoms if you understand the root cause and how to work with your body instead of against it.

I am not asking you to be “perfect” with your diet and lifestyle. Goodness knows I am not! But it is very beneficial to understand the blood sugar and insulin connection. When you do you can make the best decisions on what you eat, prioritizing rest, moving your body, and reducing stress. Doing all of these together will help you to reach your goals, and feel great!

Dr. Jamie

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