Today we're diving into insulin resistance—a condition that affects millions but often goes unnoticed until it leads to more serious health issues like type 2 diabetes and metabolic syndrome. 

Understanding what it is, how it develops, and how to manage it is important for maintaining overall health.

What is insulin?

Let's start with the basics. Insulin is a hormone produced by the pancreas that helps regulate blood sugar levels by facilitating the entry of glucose into cells for energy. When someone has insulin resistance, their body's cells don't respond properly to insulin, leading to elevated blood sugar levels.

This means the pancreas has to produce more insulin to achieve the same effect, resulting in higher insulin levels in the blood—a condition known as hyperinsulinemia. Over time, this can lead to type 2 diabetes if not addressed.

What causes insulin resistance?

So, what causes insulin resistance? Several factors contribute, including:

• Obesity: Excess fat, especially around the abdomen, can interfere with insulin's action.​

• Physical Inactivity: A sedentary lifestyle reduces the body's sensitivity to insulin.​

• Poor Diet: Diets high in processed foods and sugars can contribute to insulin resistance.​

• Genetics: A family history of insulin resistance or diabetes or belonging to Black, Asian, and/or Hispanic ethnic groups can increase the risk.

It's also important to note that certain health conditions, like high blood pressure, high cholesterol, and gestational diabetes (diabetes in pregnancy) can be associated with insulin resistance. Chronic stress and steroid medication use can also increase a person’s risk of insulin resistance.

What are the signs and symptoms of insulin resistance?

Now, let's talk about the signs and symptoms. Insulin resistance often develops gradually and may not present noticeable symptoms initially. However, some indicators include:

• Irregular menstrual cycle

• Hirsutism (excessive body hair)

• Dark Patches of Skin (Acanthosis nigricans): Areas like the neck or armpits may develop dark, velvety patches in the skin folds or creases.

• Weight gain: As glucose levels increase in the blood, the body tries to remove it by storing the excess in the liver and muscles. The excess glucose gets stored as fat.

Let’s talk about this process a little more in depth. When you consume food, your body breaks it down into glucose, which is the primary source of energy for your cells. After eating, glucose enters your bloodstream, raising your blood sugar levels. To help regulate this, your pancreas releases insulin, a hormone that signals your cells to absorb glucose for energy or storage.

Now, here's how excess glucose gets stored as fat:

1. Energy Needs Met: Your body uses glucose to fuel immediate energy needs, like physical activity or basic bodily functions. But when there’s more glucose than the body can use right away, it needs to store the excess.

2. Liver and Muscle Storage: The first place the body stores extra glucose is in the liver and muscles. This glucose is stored as glycogen, which is a form of glucose that can be quickly accessed for energy when needed.

3. Conversion to Fat: However, there’s a limit to how much glycogen the liver and muscles can store. Once these storage spaces are full, the body starts converting the remaining excess glucose into fat. This process is called lipogenesis. The glucose molecules are turned into fatty acids, which are then stored in fat cells (adipocytes) throughout your body.

4. Insulin's Role in Fat Storage: High levels of insulin, which can occur when you’re eating a lot of sugar or processed carbs, promote fat storage. Insulin doesn’t just help glucose enter cells—it also signals fat cells to store fat, preventing the body from breaking down stored fat for energy.

Over time, when you consistently consume more glucose than your body can burn, this leads to an accumulation of fat, particularly in areas like the abdomen. This is why excessive carbohydrate consumption, especially refined sugars and processed foods, can contribute to weight gain and fat storage in the body.

Essentially, the body is designed to store extra energy for times when food isn’t as readily available—but when this process happens too often (like in the case of chronic overeating or poor dietary habits), it can lead to fat buildup and weight gain.

What are the complications of insulin resistance?

• Metabolic Syndrome: Metabolic syndrome is a cluster of symptoms that includes high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol levels, which increase the risk of heart disease, stroke, and type 2 diabetes.

• Prediabetes: Elevated blood sugar levels that aren't yet high enough to be classified as diabetes.​

• Fasting blood sugar: Between 100 and 125 mg/dL (5.6 to 6.9 mmol/L).

• Oral glucose tolerance test (OGTT): A 2-hour blood sugar level between 140 and 199 mg/dL (7.8 to 11.0 mmol/L) after drinking a glucose solution.

• Hemoglobin A1C: Between 5.7% and 6.4%.

• Type 2 Diabetes: A chronic condition where the body becomes resistant to insulin, leading to high blood sugar levels.​ To diagnose diabetes using fasting blood sugar or A1C, two separate readings that meet the diagnostic criteria are required. 

• A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher on two separate occasions.

• An A1C level of 6.5% or higher on two separate occasions.

As you can see, It's crucial to address insulin resistance early to prevent these complications.

While there's no direct test for insulin resistance, healthcare providers often assess risk factors and may use blood tests to evaluate blood sugar levels and insulin sensitivity.

The good news is that insulin resistance can often be managed or even reversed through lifestyle changes. Key strategies include:

• Regular Physical Activity: Engaging in consistent exercise helps improve insulin sensitivity.​

• Healthy Diet: Focusing on a balanced diet rich in vegetables, lean proteins, and whole grains can aid in managing insulin resistance. ​

• Weight Management: Losing excess weight, especially abdominal fat, can significantly improve insulin sensitivity.​ Ideally, aim for 30 minutes of physical activity on most days of the week.

• Stress Management: Chronic stress can worsen insulin resistance, so incorporating stress-reducing activities is beneficial. (e.g., meditation, deep breathing, mindfulness, exercise, sleep management).

Thanks for listening to The Peptide Podcast. If you found this episode helpful, be sure to subscribe and leave a review. And as always, have a happy, healthy week.

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