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Signs of insulin resistance can be difficulty maintaining weight, drowsiness, fatigue, and an increased cravings for sweets, especially after a heavy meal. If we don’t respond in time, we will be on the road that leads to type 2 diabetes. What is insulin resistance and how can it be managed?
- Weight gain, drowsiness and fatigue may be the first symptoms of insulin resistance
- The expert explains what tests should be performed to confirm or exclude this disease
- It also explains what the treatment of insulin resistance looks like
- More information can be found on the Onet homepage.
- ARTICLE FROM MAGAZINE: NEWSWEEK ZDROWIE & MEDONET 2/2021
Insulin resistance – what is it?
To understand what insulin resistance is, it will be useful to review insulin briefly. It is a hormone produced by the pancreas necessary to metabolize carbohydrates, which are the basic fuel for the brain and muscles. There is no life without it. When a patient has type 1 diabetes (his pancreas produces too little insulin because the pancreatic islets are destroyed by its own antibodies), his blood glucose concentration increases, but without insulin it cannot enter the cell where metabolic reactions take place. Unused glucose circulates in the blood, causing a lot of damage to the body: it damages blood vessels, increasing the risk of heart attack, stroke, limb ischemia, blindness, and kidney failure. An insulin injection changes everything. Its administration enables glucose metabolism, thanks to which the body is nourished and its blood level is lowered.
Insulin resistance is a different situation, but also related to diabetes, but type 2.
– Although the body of a person suffering from insulin resistance produces insulin, the tissues responsible for its metabolism, i.e. muscles and the liver, do not respond to it – explains Dr. Anna Jeznach-Steinhagen, MD, Ph.D. They do not let glucose into the cell because of the excess energy stored inside. Therefore, in a person with insulin resistance, glucose levels rise after a meal and stay high for much longer than it should. In response to this, the pancreas produces more insulin (this is technically known as hyperinsulinemia) to pump more glucose into the cell and lower its blood levels. However, it is not indifferent to the body.
– High insulin levels fuel the appetite. After a meal, the patient does not feel full or feels it for a short time, and immediately after that, there is a large hunger, especially for sweets – explains the doctor. The consequence is weight gain. The more body fat, the more insulin resistant the muscle becomes. At the same time, a high concentration of insulin blocks the breakdown of adipose tissue, so excess kilos are difficult to get rid of.
To regulate the level of glucose in the blood, you can help yourself with dietary supplements. Try, for example, Cordyceps Terranova, which is recommended for diabetics and people with insulin resistance.
– In addition to overeating and inadequate physical activity, the formation of insulin resistance is also influenced by genetic factors such as the presence of type 2 diabetes or insulin resistance in close relatives – explains the diabetologist. The endocrine-active compounds present in the environment, which can intensify and even generate insulin resistance, are also important. Their source is mainly plastics and cosmetics.
The factor triggering insulin resistance is often also a high level of cortisol, i.e. the stress hormone, resulting from living in a constant hurry, excess responsibilities and difficult life situations.
Do I have insulin resistance?
A signal of insulin resistance may be weight gain, despite maintaining the current diet and physical activity, and the problem of losing weight.
Other symptoms include sleepiness, tiredness and an increased cravings for sweets, especially after a heavy meal. This is the effect of a high insulin surge, which significantly lowers glycemia, even to values lower than before a meal. We are talking then about reactive hypoglycemia.
To see if we have insulin resistance, we need to have a blood test. But beware, it is not enough to measure your fasting blood glucose. You still need to measure fasting insulin and calculate the so-called index. HOMA, which we get by dividing one result by another. A result above 2 indicates insulin resistance.
– It is also worth taking an oral glucose load test (OGTT for short), or the glucose and insulin curve. A test involving the measurement of fasting glucose (or glucose and insulin), then one and two hours after drinking a solution of 75 g of glucose. Abnormal test results are a serious warning against type 2 diabetes. “The important thing is that you can still turn back from this path,” says Dr. Jeznach-Steinhagen. Weight loss, even by 7-10%, significantly reduces the risk of diabetes.
See if you may have insulin resistance. Buy a package of diagnostic tests at Medonet Market.
How is insulin resistance treated?
The key is to follow a diet with a low glycemic index and reduced calories, increase physical activity to normalize body weight and get rid of excess body fat. For this purpose, products with a high glycemic index must be eliminated from the menu, that is: sugar, sweets, sweet drinks, white bread, pasta, rice, fatty meat, cold cuts, cheese. The basis of the diet should be vegetables and whole grains, which contain the most dietary fiber, because this lowers the glycemic index and prolongs the feeling of fullness. The exceptions are potatoes, broad beans and red beets. It is worth eating legumes, which have a lot of wholesome protein. Be careful with the fruit. You have to be content with one serving, or more or less a glass. Apples and berries have the lowest glycemic index. We avoid grapes, ripe bananas, watermelon, citrus and papaya. Milk and dairy products are also not the best option, because although they have a low glycemic index, they have a high insulin index, which means that they stimulate a strong insulin surge. So they are not advisable.
Many people complain that despite the diet and increased physical activity, the weight will not budge. Then what?
– It’s easier to get started with the help of metformin, a drug that sensitizes tissues to insulin. As a result, the appetite is reduced, especially for sweets, and smaller portions of food give a feeling of fullness, explains Dr. Jeznach-Steinhagen. However, this is not always enough. Therefore, more and more often, in patients with insulin resistance, we use drugs that treat obesity – both modern anti-diabetic preparations, which we know that help to lose weight, and drugs that affect hunger and satiety centers in the central nervous system – adds the doctor.
Insulin resistance. Helpful probiotics and herbs
Probiotics can also help you get rid of insulin resistance. Research says that overweight and obese people have a disturbed bacterial flora. Pathogenic strains, such as Firmicutes, which obtain energy from food debris, are often found in excess, and these under normal conditions are not digested. In this way, they add up to 300-400 extra calories. By using proven probiotics, we can restore the bacterial balance, and thus improve the “tightness of the intestine”, the role of which scientists are talking more and more about in the context of the prevention of metabolic disorders. Moreover, it turns out that probiotics improve the action and tolerance of metformin. It is also worth using them when using sweeteners, because we know that they disrupt the intestinal flora.
In type 2 diabetes, one of the factors influencing insulin resistance is chronic inflammation induced by “bad” intestinal bacteria producing endotoxins, eg LPS. Indeed, type 2 diabetics have higher blood levels of LPS than non-diabetics. It turns out that LPS administered intravenously to mice causes insulin resistance and obesity in them.
Research confirms that supplementation with Lactobacillus and Bifidobacterium strains reduces, among others, glucose, insulin and insulin resistance index (HOMA index) and a reduction in LPS levels, and also has a positive effect on the reduction of abdominal fat.
A lot of research also confirms the effectiveness in the fight against insulin resistance of berberine (barberry extract). – Berberine improves the sensitivity of tissues to insulin, inhibits hepatic gluconeogenesis, which is the process of creating glucose in the body from protein and fat, but also modulates the intestinal microflora – says the diabetologist. Thanks to this, it prevents non-alcoholic fatty liver disease (NAFLD), which is common in people who are overweight, obese and insulin resistant.
Remember that probiotics and supplements can improve insulin sensitivity, seal the intestinal barrier and help reduce body weight, but it is not enough to cure insulin resistance and escape type 2 diabetes in the future. The rest is in our hands. The mainstay of treatment of insulin resistance is diet and increased physical activity. They should become permanent lifestyle elements. If we give them up, insulin resistance will come back quickly.
To find out if you are insulin resistant, it is not enough to measure your fasting blood glucose. You still need to measure fasting insulin and calculate the so-called index. HOMA, which we get by dividing one result by another. A result above 2 indicates insulin resistance. It is also worth doing an oral glucose load test (OGTT for short), or a glucose and insulin curve.
Substantive consultation:
dr n. med. Anna Jeznach-Steinhagen: diabetologist and dietitian, assistant professor at the Department of Clinical Dietetics at the Faculty of Health Sciences of the Medical University of Warsaw, consultant for pregnant women at the Clinical Hospital Duchess Anna Mazowiecka in Warsaw
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