Ask the Doc

What Does it Mean to be Insulin Resistant?

What is insulin resistance, and what can I do about it?
ask the doc insulin resistant

Q: My doctor told me that I have “insulin resistance,” and that I may be headed for diabetes. What is insulin resistance, and what can I do about it?

A: The cells of your body need sugar for energy. The sugar they need is glucose, which powers your brain, muscles, and other parts of your body, just as gasoline powers a car. To get glucose into your cells, your body makes insulin, a hormone that acts like a key. It attaches to the surface of your cells, allowing glucose to enter.

For some people, the cells do not respond well to insulin. Imagine that you try to start your car and insert your key into the ignition, only to find that it does not turn very easily. Looking more closely, you discover that some mischievous person put gum in your ignition. There is nothing wrong with your key, but your ignition does not work right. This is essentially what happens in insulin resistance: The insulin “key” attaches to the surface of the cells normally, but the cells don’t respond as they should.

That’s where the problems start. If glucose cannot get into your cells, it builds up in your bloodstream. Your body responds by producing more and more insulin, eventually getting at least some glucose in the cells where it belongs. But as the years go by, your body may not be able to produce enough insulin to overcome the cells’ resistance. At that point, your cells cannot get the glucose they need. And you’ll find yourself low on energy, like a car that’s run out of gas.

Meanwhile, the glucose that builds up in your blood can harm the blood vessels in your eyes, kidneys, and heart. This condition is called type 2 diabetes, and it has reached epidemic proportions in North America and much of the rest of the world.

Q: What causes it?

A: Insulin resistance is partly genetic. But there are other important contributors. One of the most important was found by researchers using special scanning techniques. Looking into the cells of people with insulin resistance, they found tiny particles of fat. These fat particles are especially common in muscle cells. Like gum in a lock, a buildup of fat particles in cells interferes with insulin’s ability to open the cell membrane and allow glucose inside.

Researchers at Yale University scanned the muscle cells of young adults whose parents or grandparents had diabetes. Even though these young people were slim and healthy, many had microscopic fat particles already building up in their
muscle cells, suggesting that they were headed for diabetes.

These fat particles are the result of diets loaded with fatty foods, along with sugar and overly refined carbohydrates that pack in more calories than we need.

Q: Does insulin resistance cause other problems too?

A: Yes. It also contributes to polycystic ovary syndrome (PCOS). In this condition, women lose their normal ovulation cycle, which can lead to infertility. The problem is that increased insulin produced in response to insulin resistance ends up triggering changes in sex hormones, especially an increase in testosterone in a woman’s bloodstream. Symptoms of PCOS include irregular periods, weight gain, acne, and an increase in facial hair. As you can imagine, women with PCOS are at risk for developing type 2 diabetes.

Q: So if sugar is building up in the bloodstream, does that mean I should avoid carbohydrates, such as bread or rice?

A: Just the opposite. You would do better to have more healthful carbohydrates and a lot less fat. Here’s why: In Asian countries, where meals have long been centered on rice, insulin resistance and diabetes were relatively rare—until fast-food restaurants arrived. As Asian diets have Westernized over the past few decades, with increasing amounts of meat, cheese, fried foods, and sugar, diabetes rates have exploded.

Remember those fat particles in your cells? Well, fatty foods can cause them to build up remarkably quickly. In a study, researchers in Baton Rouge, La., fed high-fat meals to 10 young men. After just three days, the fat particles in the men’s cells had built up significantly. Meanwhile, a team of London researchers tested people who were following vegan diets, finding that they had significantly less fat in their muscles compared to other people.

So getting the fatty foods off your plate is a good way to “clean out” your cells, so to speak, and a good way to tackle insulin resistance. The most powerful diets set animal products aside, keep vegetable oils low, and emphasize natural foods—beans, whole grains, vegetables, and fruits. Physicians Committee for Responsible Medicine studies have shown that these foods can reduce insulin resistance, promote weight loss, and dramatically improve diabetes.

you might also like



comments

I was in the hospital my sugar was in the 400 numbers and my ketones were off the charts. Was in the hospital two weeks. I was given insulin. I checked the Feinberg Northwestern Institute for daiy recommendations. I went grocery shopping checked all the abels and combinations of food that added up to te amounts listed for every vitamin and mineral. Heres te basic menu I ate for two weeks straight. Cream of wheat with water and 2% milk. Milton's muti-grain bread 2 slices per day. One cup orange juice or one small orange a handful of sun flower seeds, 10 black olives, one tomato, brocolli, cauiflower, squash and carrots, one ounce of chicken breast, one ounce of cheddar cheese, That's all I can remember I did'nt write it down but thats about it. The main thing is the cream of wheat and miltons bread that provides you with basically most of the vitamins and minerals that you need. Also, I lowered my cholesterol levels to excellent by eating chicken breast and tomato tacos. I just wanted to share and you can try it for yourself. It's all good food. My diabetic a1c went from 8.5 to 4.7 in two to three weeks. I also noticed tat I could stop te diet and my insulin was still regulated for a month or two so I eat it at leadt once or twice a week.

Anne - 2014-07-18 21:41:50

I'm sorry, but your paragraph about foods causing the explosion of diabetes in eastern populations is factually, scientifically, and totally wrong: it is processed carbohydrates, not saturated fats etc, which cause this. There's tons of evidence about this (close to home, Alzheimer's and t2dm etc rocketed after we were told to lower fat and increase carbs) and you're literally putting people's lives at risk saying otherwise. Please, read the Harvard health guidelines, they know a thing or two, and realise our bodies are not supposed to survive on carbs. And indeed they don't.

dan - 2014-02-24 22:30:34

Nanette, you are absolutely right, grains are a problem as they have a high glycemic index and spike your blood sugar. This includes whole grains!! This article is quite misleading because up until humans started cultivating grains in the Neolithic revolution 10'000 years ago we consumed very few carbohydrates. A high protein, low carb diet is what our body is set up for genetically. Insulin production to eliminate elevated sugar in our blood stream and store it as fat in cells is an emergency measure for the rare cases where this may happen (extremely rarely for hunter gatherers), it is not meant to be the normal way we obtain energy. Thus all the problems we see with the high carb diets most people follow today. For more check out Wheat Belly, Grain Brain, Primal Blueprint etc...

wugiul - 2014-02-20 15:46:44

Interesting

Seha - 2014-02-03 07:34:31

So what do you have to say about The Real Meal revolution by Prof Tim Noakes!?

Mal - 2014-01-31 10:20:06

Your article was good, but with one omission. Humans evolved eons ago as hunter/gatherers. Insulin resistance and the weight gain that follows appeared only after humans started cultivating grains. Studies of the bodies of mummified Egyptians shows that a diet heavy in grains causes insulin resistance and obesity. Egyptians had a high rate of heart disease and obesity caused by insulin resistance. Cutting out animal products and fats will NOT cure insulin resistance. You also have to cut out "white" processed foods such as sugar, high fructose corn syrup, white bread and white pasta. A truly insulin resistant body cannot tolerate more than 15 carbs per meal without the blood sugar spiking and the liver converting that extra sugar into fat. An insulin resistant person can get overweight with high blood pressure and high blood sugar on a fat-free vegetarian diet. I know this because it happened to me!

Nanette - 2012-10-18 12:07:26

This was an awesome breakdown of this topic. You are a great teacher! Keep up the great work.

Emmyelle - 2012-07-05 15:19:51

I like the ans. given and the example of car key demonstration. You are a good teacher. Keep it up.

Eric K.K. - 2012-06-16 15:39:55

I have been diagnosed with diabetes for less than a yr. I had gestastional diabetes and was told it would come back later on in my life. I was put on insulin less 3 wks. of being diagnosed. I am insulin resistant and the doctor keeps upping my insulin and I see an endrocronologist. They had me on something call symlin to help lower my sugars. I am up to 8 shots a day now. I hope they can help me.

Anonymous - 2012-03-23 19:08:19

I agree with about half the article until it talks about how in asian countries people were fed mostly grains then when fast foods came in people started getting fat. THe REAL reason people started getting fat was because of all the carbs found in fast foods, they only raise your insulin resistance levels.. Everything they used to eat started getting deep fried, stir fried..so your mixing carbs and fat, that combination causes a huge insuline spike. Only fat (good fats like saturates, omega, olive oil) are used by our bodies for energy..yes too much of these will still make you fat, but wont spike your insulane levels like carbs do..

Buttermilk biscuits - 2011-10-15 13:17:04

By far and away this is one of the best, most informative and easy to understand articles about insulin resistance I have found. THANK YOU!

Norma Coleman - 2011-09-17 11:28:59

Will this cause me not to be able to loose weight, as I eat very healthily but cannot loose weight.

Anne - 2011-11-02 06:38:51

by linda on Feb 1st 2012 is there any sense in taking insulin if you are insulin resistant? i have recently started insulin and it doesn't seem to be lowering my blood sugar much more than my po meds. type 2 diabetic

Anonymous - 2012-02-01 16:17:10