Let’s start with some definitions:

Insulin is the hormone that “opens the door” of the cell so that glucose can move inside. Once inside, the cell metabolizes glucose and produces energy. This is a good thing! Energy production allows us to accomplish the basic functions of life. Insulin is also involved in regulation of food intake and the mechanism that alerts the body whether it should synthesize and store fat.

Glucose is the body’s preferred energy source. The body can use energy from proteins (ketone bodies) or fats (fatty acid oxidation), but they are not as efficient as glucose.

Insulin Resistance is when there is plenty of insulin available, but the door of the cell just won’t budge open. 

What if insulin resistance is left unchecked?

Unchecked insulin resistance can lead to type 2 diabetes, gestational diabetes, gallstones, metabolic syndrome, increased blood lipid levels, and other problems.

Insulin resistance is a progressive condition. A combination of many factors makes insulin resistance a “spiraling downward circle” as the effects of insulin resistance promote its continuation.

How do I know if I have insulin resistance?

The following indicate risk for insulin resistance:

  • Discolored grey-brown skin called acanthosis nigricans is a sign of insulin resistance. It is often located around skin folds
  • Fasting glucose > 100 mg/dl found on a Basic Metabolic Panel (BMP) or a Comprehensive Metabolic Panel (CMP)
  • High amounts of visceral fat (the fat in and around your abdominal organs), high blood pressure, high blood lipid levels, PCOS, obesity, type 2 diabetes, or gestational diabetes are all associated with insulin resistance
What influences Insulin Resistance?

Genetics and Lifestyle: Your genetic code is set by your DNA, however the environment controls which genes are expressed. Stress, diet, and other factors can turn genes “on” and “off”. For example, a high fat diet can promote insulin resistance and obesity by modulating certain transcription factors in DNA replication.

Stress, Toxins, and Inflammation are also associated with insulin resistance, such as the low-grade inflammation found in obesity or the toxins and stress exposed to the fetus during pregnancy.

Certain medications can cause insulin resistance, such as corticosteroids like prednisone and hydrocortisone.

Hormones and Pregnancy. The imbalance of testosterone and estrogen in PCOS can lead to insulin resistance. Insulin sensitivity also naturally decreases in pregnant women, especially in the second half of pregnancy and in pregnancies with multiples.

Diet is high consumption of fructose, including high fructose corn syrup largely found in sugar-sweetened beverages is associated with increased insulin resistance

How to decrease insulin resistance:

1. Adjust your Diet
    • Get enough Fiber. Fiber comes from whole grains, such as whole wheat bread, brown rice, and oats. You can also get fiber from fruit and vegetables, especially if you eat the skins. Sweet potatoes with the skin, peeled oranges, apples, pears, and celery are high in fiber.
    • Eat less animal fat and more plant-based fats. Butter, cream, full-fat milk, ice cream, fatty meat, pies, pastries, and other baked goods are high in saturated and trans fats, which are linked to increased insulin resistance. But don’t skip out on fat altogether! Fats from soy, nuts, seeds, and fish are associated with decreased risk for diabetes.
    • Reduce intake of soft drinks, juice, and sweetened teas. This goes back to the concept of fructose and high fructose corn syrup.
    • Reduce alcohol intake.
2. Exercise and manage stress.

Physical activity not only decreases insulin resistance; it also reduces blood sugar and is essential for sustaining a healthy weight

3. Achieve a healthier weight.

Having excess fat tissue sends hormones that set the stage for insulin resistance. Reducing weight can help change that hormone balance. Since low-grade inflammation exists in obesity, achieving a healthier weight can also reduce bodily stress.

4. Take prescribed medications.

Medications for blood glucose control prevent further damage to the body. If you would like to stop taking a medication, discuss how to safely do this with your doctor before stopping your treatment on your own. It’s natural to want to be off medications, especially if you’re experiencing side effects. Note that herbals are not safer than prescription medications. Many times, herbals follow the same pharmacological pathways that prescription medications follow, yet they are not well regulated. Talk with your doctor before starting any herbal supplements.

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