We often hear or use the term “insulin resistance” throughout regular conversation these days. We will cover her the importance of this concept not only as it relates to sugar control, but other potential negative health effects related more to insulin and not specifically to sugar
Disclaimer:
We realize that each individual is unique. While we give a general overview that applies to most people, it does not constitute medical advice for any particular person. Please consult your physician to obtain specific recommendations for your unique situation.
Where does glucose go?
Glucose gets in the bloodstream through many sources. The chief source we are considering today comes from sugar that is consumed and a meal or a food that then gets absorbed through the intestines into the bloodstream. Our bodies do not like to have a lot of sugar circulating in the bloodstream. We all know that individuals who have elevated blood sugar levels are considered to be either prediabetic or diabetic.
There are many hormones and chemicals in the body that are involved in glucose control. The main chemical in this process is insulin which is created by the pancreas. Insulin levels start to go up in anticipation of food ingestion even before sugar hits the bloodstream.
For this particular topic, the chief effect of insulin is to command the muscles to open up and absorb much of the glucose from the bloodstream. Why would the muscles want this? The muscles like to have a ready energy store already inside the muscle cell in the form of glucose, or more appropriately in the storage form, which is glycogen. This way when the muscle needs instant energy, it is already in place and does not have to be extracted from the bloodstream at that particular moment.
Normally only a small amount of insulin is necessary to signal the receptors of the muscles to uptake glucose.
Diagram showing normal glucose absorption vs. insulin resistance. Normal side has glucose entering cells; resistance side shows blocked glucose entry.
Fat cells
It appears that individuals who have a large amount of adipose tissue, or fat cells, secrete some sort of signal that reduces the muscles willingness to extract glucose from the bloodstream even in the face of insulin being present, otherwise known as Insulin Resistance. The precise mechanism is not understood but it is probably related to reduction of the number of insulin receptors on the muscle. Production of these receptors is controlled and done within the muscle cell itself.
An important aspect of the effects of insulin is that insulin also stimulates the fat cells to store excess glucose as fat. This could be a mechanism whereby individuals who have obesity have a difficult time losing fat weight
Increased insulin levels to the rescue
It makes logical sense that if the muscles are not listening to the insulin, in other words have resistance to insulin, that our pancreas can compensate by increasing the insulin level in order to issue a stronger command to the muscle to obey and absorb glucose. In many instances, this does work and higher insulin levels can bring down the blood glucose by having it shuttled into the muscle cell. So now the blood glucose is back down to a normal level. Problem solved?
Potential negative effects of increased insulin levels
At face value it would seem that ever increasing insulin levels are a good response to help bring down her blood sugar levels as the glucose is shuttled into the muscle cell. As mentioned earlier, those increased insulin levels also shuttle glucose into the fat cells for energy to be stored as fat. That effect of increased insulin levels, or hyperinsulinemia, is certainly not a good result as excess fatty tissue has its own associated problems..
Insulin and related compounds are also felt to have a negative effect on the lining of the blood vessels. The inner lining of the blood vessels, or endothelium, is a very active and important portion of our circulatory system. Insulin has the ability to cause changes to that endothelium which is a likely contributor to increased risk of vascular disease, stroke, coronary artery disease, and peripheral vascular disease.
Hyperinsulinemia also stimulates growth of other cells in the body which some experts see as a condition which may increase the risk of the growth of certain cancers.
So hyperinsulinemia is seemingly a beneficial adaptive response to bring down blood glucose levels in the face of insulin resistance. However, this response is associated with a number of other potential negative effects.
Do I have insulin resistance?
Insulin levels can be obtained with a simple blood test. They can be done as a simple fasting morning specimen or they can also be done as part of a glucose tolerance test. A glucose tolerance test simply is where a person consumes a glucose load, typically in the form of a sweetened beverage, and periodically blood tests are drawn, which measure simultaneous glucose and insulin levels to see how the body responds to any particular blood glucose level. Typically such a glucose tolerance test is not necessary
Measuring insulin levels certainly could be wise to be done in individuals who have abnormal blood sugars on routine blood testing, individuals diagnosed with diabetes, folks that are overweight or even folks who have a diet that happens to be very high in carbohydrate intake.
If your insulin level is high compared to what your glucose is, even if her glucose level is normal, then you may have insulin resistance.
Treatment
Clearly the most effective way to counteract insulin resistance is to markedly reduce one’s carbohydrate intake. Protein intake can be very liberal as high levels of protein intake do not have a negative effect on insulin. Keeping carbohydrate intake to less than 70 g a day is probably a good start but can be a challenge for many.
Weight loss is another hallmark treatment. This may also be done with very low carbohydrate intake but other methods such as GLP-1/GIP medications, which are typically used for the treatment of diabetes can also be helpful. In more severe situations we see improvement of insulin resistance in obese individuals who have undergone bariatric surgery to lose weight.
Insulin resistance is a crucial health condition that can have far-reaching effects on not only blood sugar control but also overall health. It is characterized by the body’s inability to respond properly to insulin, leading to higher insulin levels and potentially contributing to weight gain, vascular issues, and even increased cancer risk. Addressing insulin resistance early on is essential, and adopting lifestyle changes such as reducing carbohydrate intake and focusing on weight loss can be effective in reversing or managing the condition. Regular testing, especially for those at risk, is key to identifying insulin resistance before it leads to more severe health issues.
If you suspect you may be at risk for insulin resistance, or if you’re already managing related health conditions like diabetes, we encourage you to take action today. At Infinity Health DPC, we provide personalized care and treatment plans tailored to your specific health needs. Schedule a consultation with us to discuss your concerns, get tested, and begin managing insulin resistance with expert guidance. Take control of your health—contact us at Infinity Health DPC today to start your journey toward better health!
Article sources:
- American Diabetes Association. “Insulin Resistance and Prediabetes.” Diabetes.org, 2024.
- Mayo Clinic. “Insulin Resistance: Symptoms and Causes.” Mayo Clinic, 2023.
- National Institute of Diabetes and Digestive and Kidney Diseases. “Insulin Resistance & Prediabetes.” NIDDK.nih.gov, 2024.
