What is Insulin Resistance and How Is It Caused?
No conversation about type 2 diabetes is possible without discussing and understanding insulin resistance. Long before a diagnosis of pre-diabetes or diabetes, high insulin levels and subsequent insulin resistance has likely been going on for many years.
Insulin is a hormone made by the body in response to rising blood glucose. Blood glucose rises for many reasons, food intake (predominantly carbohydrates), stress, illness, hormone changes, etc….(carbohydrates being one of the greatest contributing factors.) Carbohydrates turn into glucose, and need insulin to facilitate entry into our body cells to be used for fuel. When a person is insulin resistant, the cells are not “responding” to the insulin. So the glucose stays in the bloodstream and raises to dangerous levels. Although insulin resistance is the hallmark feature of Type 2 diabetes, you may be showing signs of insulin resistance for years, well before an actual diagnosis of Type 2. THIS is when it should be fixed. Don’t wait until a diagnosis!
What causes insulin resistance? There are lots of things that can contribute to insulin resistance, many of them having to do with our lifestyle (poor diet, being sedentary, poor sleep habits, excessive stress). But the biggest culprit by far is one we can do something about. And if we address this problem, we can go a LONG way at reversing insulin resistance and the stopping the progression toward Type 2 diabetes. What is it? Simply put…too much insulin. That’s right! Would you be surprised to know that Type 2 diabetes is precipitated by too much insulin? That “doesn’t make sense” you say. “I Have Type 2 diabetes and NEED insulin because I don’t make ENOUGH.” So what do I mean?
Let’s trace the root causes of Type 2 diabetes. And we are not going to get into genetics here. Although Type 2 does have a fairly strong genetic component, it is, predominantly , lifestyle related. A well known adage states, “genetics loads the gun, but environment pulls the trigger.” In other words, while there is no doubt there is a genetic link, it is not the most predominant factor (we are also not going to focus here on age, race or gender, although these are also risk factors). In addition, often, when this type of diabetes runs in families, it is not simply because of a genetic pre-disposition, but because families raised in similar environments with similar lifestyle practices are more likely to develop similar disorders. So we’re going to focus on what we CAN do about diabetes, despite the genes we have inherited. While we cannot change our genetics, we CAN change how our genes “express” themselves.
So…back to our original topic…what predominantly causes Type 2 diabetes…is it a problem of too MUCH or too LITTLE insulin…..easy answer: too MUCH!
Let’s let Dr. Perlmutter answer this question in more detail. The following is an excerpt from his book, “Grain Brain”…
“The process by which our cells accept and utilize glucose is an elaborate one. The cells don’t just suck up glucose passing by them in the blood stream. This vital sugar molecule has to be allowed into the cell by the hormone insulin, which is produced by the pancreas. Insulin, as you may already know, is one of the most important biological substances for cellular metabolism. Its job is to ferry glucose from the bloodstream into the muscle, fat and liver cells. Once there, it can be used as fuel. Normal, healthy cells have a high sensitivity to insulin. But when cells are constantly exposed to HIGH LEVELS OF INSULIN as a result of a persistent intake of glucose (much of which is caused by an over consumption of hyper-processed foods filled with refined sugars that spike insulin levels beyond a healthy limit), our cells adapt by reducing the number of receptors on their surfaces that respond to insulin. In other words, our cells desensitize themselves to insulin, causing insulin resistance, which allows the cells to ignore the insulin and fail to retrieve glucose from the blood. The pancreas then responds by PUMPING OUT MORE INSULIN. So higher levels of insulin become needed for sugar to enter the cells. This creates a cyclical problem that eventually culminates Type 2 diabetes. People with diabetes have high blood sugar because their body cannot transport sugar into cells, where it can be safely stored for energy. And this sugar presents many problems…too many to mention. Like a shard of glass, the toxic sugar inflicts a lot of damage, leading to blindness, infections, nerve damage, heart disease, and yes…Alzheimer’s. Insulin also promotes fat formation and retention and encourages inflammation.”
So, let’s look at a graphic of the cycle of insulin resistance:
And Type 2 diabetes is not the only disease associated with high insulin levels. High insulin levels are at the heart of most chronic disease.
So, while Type 2 EVENTUALLY may lead to a deficiency in insulin production necessitating the need for injected insulin, the condition is initially precipitated by TOO MUCH INSULIN. When your body has elevated insulin levels repeatedly over time, your cells will slowly fail to respond to insulin. What causes the elevated insulin levels? As Dr. Perlmutter pointed out, typically, it is a DIET HIGH IN CARBOHYDRATES. And it is not just the AMOUNT of carbohydrates, but the FREQUENCY with which we eat them.
Generally, when we eat a meal that is high in carbohydrates, insulin responds quickly. The large insulin load often causes a person’s blood sugar to drop quickly. Within a short period of time, a person will become hungry due to the quick fall in blood sugar, even though they still have plenty of blood sugar circulating in the body. And what would they crave? Not a steak! But rather a bag of potato chips, pretzels or crackers.
Remember, quick spikes equal more insulin, equal quick drops. Then hunger signals cause a person to eat again before they have even returned to baseline. So blood sugar goes back up, and so does insulin. And once again what does chronic elevated insulin levels lead to? You got it…tolerance…or in other words…resistance. Look at this graphic and see the difference between eating a meal with a large carb load or one with a small carb load. These constant fluctuations in blood sugar are unhealthy and damaging.
Incidentally, the suggestion that we have all heard to eat “several small meals a day” or to snack on carbohydrates to “keep our blood sugars up” is dead wrong. We don’t need our blood sugars up. We need them normal and stable. Eating carbohydrates causes cravings for more carbohydrates.
Notice also, there’s a secondary problem going on as well. In the presence of insulin the body is signaled to stop burning its own fat for fuel, and switches to fat storage mode. So what happens to all of those carbs you have to then snack on? They store as fat….and typically store as the worst kind of fat…dangerous belly fat.
Here is what happens when insulin resistance progresses.
Here is another helpful article that can help you understand the mechanisms behind insulin resistance HERE
So, how can you reverse insulin resistance? Adopting a diet low in carbohydrates will help to stop the vicious cycle of blood sugar spikes, insulin response, and fat storage, all leading to insulin resistance. Focus on higher quality carbohydrates like non-starchy vegetables, some nuts, full fat dairy, and maybe small amounts of low sugar fruit like berries. Eliminate fast acting carbohydrates like sugar, flour, grains and starches. (NEVER drink your carbs.) Allow at least 4-5 hours in between meals, without snacking on carbs. This will allow your blood sugar levels to return to normal. Allow yourself a true fast daily where you don’t eat from 2-3 hours before bedtime, all the way until breakfast. (We are supposed to fast nightly. That is why breakfast was named such….the meal that “breaks our fast.”) Exercise can also help reduce insulin resistance, but is really only going to be effective when accompanying a healthy diet.
Here are some articles by Dr. Mark Hyman on insulin resistance and appopriate tests to determine your risk. The articles do a great job of explaining insulin resistance, but his follow up dietary recommendations still include some foods that provoke insulin levels too high, such as fruits and grains. (See my article “Should I Eat Fruit? How About Grains, Starches and Legumes?” HERE)
Dr. Hyman Articles:
“The One Test Your Doctor Isn’t Doing a That a Could Save Your Life” HERE
“Are Diabetes and Insulin Resistance Reversible? The Facts” HERE
Watch this extremely informative video by Dr. Sarah Hallberg, an obesity and Type 2 specialist which sums up this page in a very powerful way.
HERE IS THE AMAZING WEBSITE OF DR. GEORGIA EDE, Diagnosis Diet, WHICH CONTAINS EXCELLENT RESOURCES ON INSULIN RESISTANCE.
ARTICLE: HOW TO DIAGNOSIS, PREVENT AND TREAT INSULIN RESISTANCE HERE
You can read my story to find out how I reversed my insulin resistance.
Click on the photo to read my free ebooklet.
Good health to you!