Diabetes. Insulin resistance. Carbohydrate intolerance. Blood sugar problems. These terms come up frequently in the news, radio and the web. Often, they’re used in ways where it is expected people understand what they mean. Unfortunately, that’s not the case.
If a term like insulin resistance doesn’t mean much to you, you’re likely to tune out the message surrounding it. You don’t need to be a Diabetologist or Endocrinologist to understand the fundamentals of insulin resistance. In fact, if you do understand the fundamentals of this condition, it’s more likely you’ll go out of your way to steer clear of it.
Guide to Insulin Resistance – The Basics of Blood Sugar
We’ll work our way to insulin resistance by starting with the basics of blood sugar.
The body must maintain a tight control of the sugar levels found in the blood. The ideal level is generally 70-100 mg/dL. More than likely, you had your fasting blood sugar levels tested the last time you did a routine blood test.
Levels below 70 mg/dL indicate hypoglycemia, or low blood sugar. When blood sugar levels are too low for too long, it can lead to trouble thinking, or even cause one to pass out. In extreme cases, it has the potential to cause a coma. Most people who eat the Standard American Diet experience periods of hypoglycemia following meals. The low blood sugar is not caused by eating too few carbohydrates at their meals, but more than likely too many. We’ll get to why this happens shortly.
Hyperglycemia, on the other hand, is high blood sugar. Blood sugar above 100 mg/dL may indicate insulin resistance, and above 130 mg/dL is the usual cutoff for diabetes. Keep in mind these are fasted blood sugar readings. Immediately following meals, it’s natural for blood sugar levels to rise somewhat. Even after a meal of meat and vegetables, blood sugar rises due to the carbohydrates found in vegetables. Protein also causes blood sugar levels to rise somewhat.
When blood sugar levels rise, the body quickly responds with attempts to lower the levels back down. If blood sugar levels stay up, it becomes toxic for many of the body’s cells and can lead to a high level of cellular “rusting” or glycation to occur.
You may hear people say glucose is the body’s preferred fuel source. They’re completely wrong. Rather, when someone eats carbohydrates, the body immediately uses them for fuel in an attempt to lower blood sugar levels. The body’s preferred fuel is fat.
Of course, following a meal, the body can’t burn enough glucose fast enough to lower blood sugar, so it attempts to store most of it.
To reiterate, the body needs to maintain a fairly steady level of blood sugar, generally between 70-100 mg/dL, but ideally closer to 70-85 mg/dL.
Guide to Insulin Resistance – Insulin
Insulin is the primary hormone that keeps rising blood sugar levels under control. The pancreas secretes insulin. When insulin reaches the cells of the liver, muscles and fat, it helps move glucose (blood sugar) inside. If there’s enough room in the muscles and liver, they’ll take up the glucose first.
Most of the time, people eat far more carbohydrates than their muscles and liver need, and the extra gets stored in the fat cells.
Before food is even digested and carbohydrates enter the blood stream, the body senses carbohydrate, or sugar is on its way. Sensors in the mouth send signals to the pancreas that blood sugar levels will be rising soon. In response, the pancreas starts secreting insulin. As a side note, some theorize that artificial sweeteners may cause elevated insulin levels because taste receptors sense something sweet is being consumed. I haven’t seen anything conclusive on this, but it’s an interesting idea.
Low blood sugar, in the short-term, can be worse than blood sugar that’s too high. When blood sugar is too low, another hormone called glucagon is secreted to help drive blood sugar back up. Cortisol, the body’s main stress hormone is also secreted. Hypoglycemic individuals feel lethargic, like they’re in a state of brain fog, common mid-afternoon for those who make poor dietary choices.
Hypoglycemia can also occur during exercise, especially for those who load up on carbohydrates or sugar before their high-intensity exercise session.
In the long-run, the real issue is when people eat excessive amounts of carbohydrates day after day. The pancreas has to keep secreting insulin, which is hard on the pancreas itself. In addition, the liver, muscle and fat cells stop responding to insulin the same way.
An easy to understand analogy is the effects of loud music. When a live concert begins, the music sounds almost deafening. As the concert progresses, the noise level sounds more normal. Your ears adapt to the loud noise and you become less sensitive. When you leave the concert, normal levels of noise are hard to hear. Your ears must recover from the noise. Eventually, hearing returns to normal.
The cells in your liver, muscle and fat behave the same way. When they’ve been hit with too much insulin for too long, they don’t “listen” to its message as well. As a result, blood glucose levels don’t drop as quickly as they should. Since blood sugar doesn’t drop, the pancreas secretes more insulin.
A trend in increasing blood glucose and insulin is a sign of insulin resistance. Your cells are becoming resistant to the signal of insulin.
Fortunately this can be corrected through nutrition. Unfortunately, all too often, nutrition isn’t corrected and the next level of blood sugar dysfunction is diabetes.
If a doctor tells you you’re developing signs of insulin resistance, take it very seriously. You’re damaging your pancreas and many other tissues by living with elevated insulin and blood sugar levels.
Guide to Insulin Resistance – Insulin Sensitivity
While I’m a huge fan of exercise, it actually has a minimal effect on improving insulin sensitivity. What exercise does do, especially resistance exercise/strength training, is help increase lean body mass. The muscle you build with resistance training is called type II muscle, and this kind of muscle helps store glucose. Adding lean mass provides more space to store carbohydrates. Also, following exercise, the body more efficiently stores glucose because it can do so without insulin.
Nutritional strategies improve insulin sensitivity the most. Step one is to reduce carbohydrate intake. STOP doing the damage.
Using the concert example above, if you went to a concert every night, you could eventually experience some permanent hearing loss. To heal, you’d need to stop going to concerts for a while. For your body to recover from insulin resistance, you need to stop adding fuel to the fire.
In time, insulin sensitivity can be restored. Along with it, many people experience weight loss as well. As insulin sensitivity improves, normal insulin levels drop. As insulin drops, the body is able to burn fat for fuel instead of storing it.
In addition to dietary changes, supplements such chromium, magnesium, berberine and others can help improve insulin sensitivity as well as control cravings for carbohydrate-rich foods. Since people respond differently with nutritional supplements, it may take some experimentation to determine which ones work best for you. If you can, try to work with a holistic nutritionist/dietitian or an integrative doctor to map out the best strategy.
Guide to Insulin Resistance – Summary
Dietary carbohydrates are the primary cause of elevated blood sugar. Elevations in blood sugar stimulate the production of insulin. Insulin should help drive blood sugar levels back down to normal if the muscle, liver and fat cells respond to insulin. If the cells are exposed to too much insulin, too often, because blood sugar levels are constantly elevated from too much carbohydrate in the diet, they stop responding. Blood sugar levels rise and extra insulin must be secreted, because the cells have lost sensitivity to insulin. They can regain their sensitivity by giving them a break from exposure to so much insulin. They get a break from insulin exposure by cutting back on carbohydrates.
All that said, some people tolerate carbohydrates better than others. You may need to follow a low carbohydrate diet for the rest of your life while your best friend may be able to eat all the carbs he or she likes. No two people are the same. However, if your blood sugar levels are elevated, or if you experience episodes of hyper/hypoglycemia you know you’re probably eating too many carbohydrates. Also, insulin resistance is not the only condition related to excessive carbohydrate consumption. Dementia, some cancers, hypertension, and other cardiovascular diseases as well as some autoimmune and inflammatory conditions are also related.
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