Insulin is a hormone involved in several processes within the body, among which the control of blood sugar (amount of sugar in the blood) is certainly the best known, although it is not the only one.
Insulin resistance is the condition in which cells respond less to the signals conveyed by this hormone; it is extremely common in the population, so much so that studies carried out in the United States have found a more or less severe form in more than 30% of the inhabitants. It is an extremely common disease. But not insignificant for this, it is in fact involved in the genesis of well-known diseases such as type 2 diabetes mellitus and polycystic ovary syndrome.
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WHAT IS INSULIN AND WHAT ARE ITS FUNCTIONS
Insulin is secreted by the pancreas and its main role is to regulate the number of nutrients that circulate within the blood. While this hormone is primarily involved in managing sugar levels – especially glucose. It also influences the metabolism of proteins and fats.
After digesting a meal containing carbohydrates, blood sugar levels rise as intestinal absorption occurs. In response, the pancreas releases insulin into the blood, reaching the cells of different tissues and signaling them to withdraw circulating glucose, with the result that the blood levels of this sugar decrease. This function is particularly important as glucose in too high quantities can have toxic effects. Causing damage to cells and even death if the situation is not resolved.
In the case of insulin resistance, cells stop responding to insulin when it reaches their surface; in response, the pancreas produces even greater amounts of the hormone. The amount of which in the blood increases further leading to a condition called hyperinsulinemia. This aggravates the situation even more, with the result that in a short time there will be an increase in both insulin and blood sugar levels. The result of the body’s ineffective attempt to contain the circulating quantities of sugars.
When the concentration of glucose in the blood vessels (glycemia) exceeds a certain threshold, type 2 diabetes is diagnosed, unfortunately, an increasingly common disease due to the worsening lifestyle (in Italy more than 3 million people are affected). And yet still somewhat underestimated. Despite the dramatic impact it can have on health.
CAUSES
Several factors can contribute to the development of insulin resistance. But the most underestimated by patients themselves is the increased amount of circulating fats in the blood (generically described as cholesterol). In fact, several studies have shown how the latter can influence the sensitivity of cells to insulin, decreasing it.
The increase in fat in the blood is mainly due to the high-calorie diet and excess adipose tissue, which is the form in which reserve fat is accumulated potentially without limits.
If overeating, overweight, and obesity are among the main risk factors, not all forms are equally dangerous; fat can be localized in different areas of the body depending on genetics and sex. For example, in women, it is more frequent to find the accumulation on the buttocks and thighs, while in men in the abdomen – albeit with exceptions – but above all, it can collect
- MORE SUPERFICIALLY (SUBCUTANEOUS FAT)
- DEEPER, AROUND THE ORGANS (VISCERAL FAT).
This second modality is the most dangerous, as quantities of fatty acids and inflammatory substances tend to be released into the blood which leads the cells to insulin resistance.
Despite the important role of fats, it should be emphasized that the condition of insulin resistance can also afflict people of normal weight or underweight. There are in fact other possible causes:
- High levels of fructose when coming from added sugars, not when consumed with fruit (which is on the contrary often associated with better glycemic control);
- Chronic inflammation;
- A sedentary lifestyle, as physical activity tends, on the contrary, to increase the sensitivity of cells to insulin;
- Alterations of the intestinal microbiota: in the intestine, there are billions of bacteria in perfect balance with each other and with our body. If their environment deteriorates, this can have negative consequences for their metabolism, including insulin resistance;
- Genetic factors, in fact, some ethnic groups – such as African, Hispanic, and asian – are more at risk.
SYMPTOMS
Unfortunately, insulin resistance is not related to the development of symptoms; its course is silent and therefore often not recognized by the patient.
COMPLICATIONS AND RELATED CONDITIONS
Insulin resistance is primarily associated with metabolic syndrome. A condition that sees the presence in the same individual of various risk factors. Both for type 2 diabetes and cardiovascular disease, and more. The signs and symptoms are high blood pressure, high triglyceride, and blood sugar levels. But also too low HDL cholesterol – called “good” cholesterol.
The best-known link, however, is that with type 2 diabetes, in which however there is also damage to the prancreas.
Insulin resistance is also sadly linked to cardiovascular disease, the leading cause of death in the world to date. People with insulin resistance or metabolic syndrome are 93% more likely than those who are healthy to develop a disease of the circulatory system (including stroke, heart attack, …).
Finally, some studies have also found a certain relationship with other diseases. For example, NAFLD – that is the accumulation of fat inside the liver not due to alcoholism -, polycystic ovary syndrome, Alzheimer’s disease, and various forms of cancer.
DIAGNOSIS
In the absence of symptoms and signs, diagnosis often occurs randomly. For example during tests prescribed for other conditions (such as in the case of infertility, when the presence of polycystic ovary syndrome is suspected). Or as a result of observation of known risk factors, such as body weight, adipose tissue distribution, and blood fat levels, by the physician.
There are several methods for making the diagnosis of insulin resistance. The ones listed below are the most used in medical practice.
Chief among them is the glucose tolerance test. A mixture of water and sugar of a known amount is given orally. And after 2 hours the blood glucose levels are measured.
Alternatively, a mathematical index called HOMA-IR, which is specific for insulin resistance, can be used.
Finally, there is the direct measurement of insulin in fasting blood. As particularly high values of the latter represent accurate indicators of low sensitivity.
DIET AND OTHER REMEDIES
Various researches have shown how changes in one’s lifestyle can significantly improve the condition. In some cases even allowing a full regression:
- Increase physical activity, because it is able to further stimulate the sensitivity of cells to insulin, with an almost immediate effect;
- Losing weight by combining diet and exercise. Especially if the adipose tissue is collected around the abdominal viscera;
- Quit smoking ;
- Improve nutrition, limiting packaged foods and sugary drinks and favoring plant-based products, whole grains, and fish;
- Increase the consumption of omega 3 fatty acids. For example fish and oilseeds (flax, chia, hemp, …), have a direct effect on reducing the number of triglycerides in the blood.
- Improve the quality and quantity of night rest ;
- Reduce stress, for example through breathing and meditation techniques;
- Donating blood, especially when high levels of iron are detected, is related to insulin resistance;
Intermittent fasting is a practice that is not well known. But feasible without too much difficulty (exclusively through specialized medical personnel).
The list just presented shows the main changes that, once implemented. Have shown a positive impact both on this specific condition and on the quality of life in general. But it is always good to keep in mind that it is essential to contact your doctor to evaluate which ones are the best options based on your overall health.
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