Understanding insulin resistance


As we work this month to reduce our sugar intake, it’s important to explore the more extreme side effects of the sweet stuff. Angela LaSalle, MD, ABoIM, medical director, Parkview Physician's Group – Integrative Medicine, walks us through one of those alarming pitfalls, insulin resistance.

The long-term effects of a high sugar diet are many. Diabetes and obesity are just the tip of the iceberg. In fact, a high sugar diet has been implicated in many other severe and chronic diseases like heart disease, stroke, hypertension, arthritis, autoimmune diseases and even cancer. The common denominator here is inflammation, which is caused by the combination of higher blood sugars and excess insulin being produced by the body.

Insulin is a hormone produced by the beta cells of the pancreas in your abdomen. These are the only cells in your body that produce insulin. If you lose them, like with an autoimmune disease such as Type 1 diabetes, your body cannot get glucose into your cells. We must have insulin to live. However, many people have an issue with their cells not listening well to the insulin, which is Type 2 diabetes.

Here’s an easier way to understand this …
Picture a doorman with a shiny hat standing in the entrance of a large office building in New York City. When Miss Glucose arrives from the traffic of the blood stream, the doorman quickly, with ease, swings open the door so she can sweep into her meeting inside the cell that is all about energy production. Miss Glucose can’t open the door by herself, so if there are no doormen, she can’t get in. This is Type 1 diabetes.

When a person has insulin resistance, the hinges on the door are broken. Now, instead of one doorman, it takes three or four molecules of insulin to do the same work to open the door. In the early stages, the doormen are able to get the door open in time, so there is no delay for Miss Glucose. But as time goes on and the hinges break down more and more, glucose starts to collect on the sidewalk. This is when we begin to see the blood sugars get higher on blood tests. Eventually the glucose gets high enough that the patient is classified as having Type 2 diabetes. Note that in the early stages of this condition, it’s just the doormen that are collecting in the system, the insulin molecules.

The net result of too many insulin doormen is an increase in the activity of our fat cells, especially the fat in and around our belly. This type of fat actually produces hormones and substances that affect our immune system and put it in overdrive. Inflammation is actually part of our healing mechanisms, yet if it gets turned on too aggressively, it actually works against us and causes our tissues to be damaged. The result is we may have issues with weight gain, joint pain, and changes in our blood vessels, which then, in turn, cause pain or disease like heart disease, diabetes, etc.

Signs of insulin resistance

  • Weight gain around the midsection
  • “Low blood sugar” symptoms like feeling weak or irritable if you miss a meal or eat sugar
  • High blood pressure
  • High cholesterol
  • Abnormally high liver enzymes on blood work
  • Darkening of skin in your armpits, groin fold at top of leg or behind your neck
  • Facial hair, or thinning of scalp hair
  • Fasting blood sugar greater than 100
  • Hemoglobin A1C higher than 5.5 (gives a 3 month average of your blood sugars)
  • Sleep disruptions, especially waking around 3 a.m.

If you are noticing any of these symptoms, or if you have a family history of diabetes, talk to your doctor about checking a Hemoglobin A1C and a fasting insulin level. Studies have shown that early intervention with changes in diet and exercise can be as effective as prescription medication to improve your body’s sensitivity to the insulin signal. Adding some weight training to your exercise can go a long way to help improve insulin’s capacity to get glucose into the cell. You might say that it is like putting WD-40 on the broken hinges of the doors of the insulin receptors to improve your body’s ability to get glucose into the cell.

If needed, your doctor can prescribe medications, and advise on supplements and diet changes that can help to overcome the resistance that your cells have to your body’s insulin signal. If you haven’t exercised in some time or have an injury or condition that might interfere with exercise, talk with your doctor. After clearing you to start an exercise program, he or she can guide you to a physical therapist or trainer to help you get started safely.

For more information on Integrative and Functional Medicine at Parkview Regional Medical Center, visit us online or call (260) 672-6590.