Insulin Blood Sugar And Type 2 Diabetes
Insulin is a key player in developing type 2 diabetes. This vital hormoneyou cant survive without itregulates blood sugar in the body, a very complicated process. Here are the high points:
- The food you eat is broken down into blood sugar.
- Blood sugar enters your bloodstream, which signals the pancreas to release insulin.
- Insulin helps blood sugar enter the bodys cells so it can be used for energy.
- Insulin also signals the liver to store blood sugar for later use.
- Blood sugar enters cells, and levels in the bloodstream decrease, signaling insulin to decrease too.
- Lower insulin levels alert the liver to release stored blood sugar so energy is always available, even if you havent eaten for a while.
Thats when everything works smoothly. But this finely tuned system can quickly get out of whack, as follows:
- A lot of blood sugar enters the bloodstream.
- The pancreas pumps out more insulin to get blood sugar into cells.
- Over time, cells stop responding to all that insulintheyve become insulin resistant.
- The pancreas keeps making more insulin to try to make cells respond.
- Eventually, the pancreas cant keep up, and blood sugar keeps rising.
How To Test For Insulin Resistance With An Insulin Response To Glucose Test
There are some people whose fasting insulin may be normal, yet their insulin response to dietary glucose isnt.
To test this, youll need to work with a healthcare professional or research lab. You drink a small cup of 75 grams of pure glucose and immediately get your blood drawn every 30 minutes for two hours.
There are a couple ways to assess insulin resistance with this method. The numbers Im sharing with you here come from Dr. Bikmans book Why We Get Sick.
How To Reverse Insulin Resistance
Living a low insulin lifestyle is the best, most effective way to lose weight, get healthy, and prevent disease. I truly believe that testing insulin resistance will be the new gold standard for predictive medicine in the future because its at the root cause level for so many diseases like type 2 diabetes, heart disease, dementia, and arthritis.
Even if youre at a healthy weight, you may have insulin resistance and not know it – remember that its present in up to 85% of adults.
The scale certainly doesnt tell the whole story, and in fact I believe a number on the scale is one of the lowest value indicators for your health.
To the degree in which you accept responsibility for your health, you can expect to get results. Its going to take time. Its going to take patience. Its going to take focus and consistent effort. Theres no quick fix here. It probably took you a long time to develop unhealthy habits, and those grooves are deep in your brain.
Give yourself plenty of patience and grace on your journey to better health. Remember you have a lifetime to get healthy, and you need to stay healthy for the rest of your life.
to download a free masterclass that tells you how to reverse insulin resistance and lower your inflammation.
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What If My Doctor Wont Approve These Insulin Resistance Tests
From personal experience, I find that some doctors only want to test blood glucose and/or HbA1c, and if theyre normal then they wont do the other tests. This could lead to you being missed for a few reasons:
- Blood glucose is the last marker to be affected, even when insulin is struggling.
- Your blood sugar could be normal, but very, very close to the cut-off.
- This is just a one-off blood reading, and therefore it could be abnormally high or low at that one point in time.
- The medical normal range is far to high.
You really need to have your insulin measured, and I would recommend that this be done with an Insulin assay- thats an oral glucose tolerance test with insulin .
However, if your GP really refuses to approve these tests, you can opt to pay for them privately. I often order the glucose tolerance test for my patients, and as an indication, in the UK it is around £20 and in NZ about $40.
F Stands For Fasting Blood Glucose
Your fasting blood glucose value is a key indicator of your level of insulin resistance, and is important to monitor daily when living with any form of diabetes. As you become more insulin sensitive, your fasting blood glucose is likely to decrease.
Monitoring your daily fasting blood glucose is a simple way to measure how your diet is affecting your glycemic control. The goal is to achieve a consistent fasting blood glucose between 80-100 mg/dL.
As you transition to a low-fat, plant-based, whole-food diet, you are likely to experience fluctuations in your fasting blood glucose, but an overall downward trend is a great indicator of increased insulin sensitivity.
Fasting Blood Glucose Target: 80-100 mg/dL
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Raising Awareness To Save Lives
Itâs my mission to stop people from progressing to diabetes, and to help people lower their level of insulin resistance. Thatâs why I want to help people find out about insulin resistance at the beginning stages. In the early stages of insulin resistance, or in pre-diabetes, itâs possible that glucose tests will be normal but insulin tests are not normal.
REFERENCES
How Does Insulin Resistance Affect My Body
The development of insulin resistance typically increases insulin production so your body can maintain healthy blood sugar levels. Elevated levels of insulin can result in weight gain, which, in turn, makes insulin resistance worse.
Hyperinsulinemia is also associated with the following conditions:
You dont have to have all four of these features to have metabolic syndrome.
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How You Can Prevent Or Reverse Insulin Resistance
Losing weight, getting regular exercise, and not skimping on sleep can all help improve your insulin sensitivity. Dont rely on dieting or exercise alone: In one fascinating University of New Mexico School of Medicine study, published in the International Journal of Obesity, overweight people who lost 10% of their weight through diet plus exercise saw insulin sensitivity improve by an impressive 80%. Those who lost the same amount of weight through diet alone got a 38% increase. And those who simply got more exercise, but didnt lose much weight, saw almost no shift in their level of insulin resistance.15
Turn in on time, too. In a study presented at the 2015 meeting of the Obesity Society, researchers found that just one night of sleep deprivation boosted insulin resistance as much as eating high-fat foods for six months.16
> Signs That You Have May Insulin Resistance
Having several of the following may also be indicators of insulin resistance :
- You are middle-aged or older and overweight
- Increased abdominal circumference with a waist measurement of 35 inches or greater for a woman and 40 inches or greater for a man
- Increased Waist-Hip Circumference Ratio is associated with abdominal obesity and insulin resistance. This test is even more accurate than the waist measurement alone. A diagnosis of abdominal obesity is made if the waist-hip ratio is equal to or higher than 0.8 in females, and equal to or higher than 1.0 in males. For example, if your waist is 32 and your hips are 35 -> 32 divided by 35 = .91. This would indicate abdominal obesity. This can be helpful test that you can do on your own. And even if you are lean, high WHR levels are associated with insulin resistance markers.
- Waist to height ratio . < 42 very slim> 50 increased risk for insulin resistance and type 2 diabetes
- Acanthosis nigricans
- Skin tags
- Meeting 3 out of the 5 criteria as noted above
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How Is This Different From Type 2 Diabetes
Once the cells are unable to use the glucose, it remains in the bloodstream. The body senses the high glucose and tells the pancreas to secrete more insulin to deal with the excess glucose. Eventually, over years, the pancreas is unable to keep up. The glucose levels remain high in the bloodstream, and diabetes is then diagnosed by a blood test. When someone is diagnosed as diabetic, the pancreas makes little or no insulin because it can not do it anymore. Medications lower the glucose in the blood to allow the cells to use it. Uncontrolled diabetes can wreak havoc on the body and lead to hardened arteries in the heart, eyes, legs, and kidneys. You can refer to my previous post on the causes of insulin resistance.
Physical Activity And Exercise
Muscles burn glucose for energy. The more you move, the more glucose your muscles take out of the blood for energy use, which helps to lower your blood sugar levels. This allows for a reduction in insulin secretion, lessening the burden on your pancreas.
Likewise, muscles that dont move dont use up blood sugar, so insulin levels can rise to process any excess. Studies show that a mere five days of bed rest induces a state of insulin resistance in completely healthy volunteers.27 Multiple studies show that long-term inactivity is strongly associated with insulin resistance, metabolic syndrome and pre-diabetes.28
Any type of regular movement can help. Studies suggest that high-intensity interval training , resistance training, and cardio training all improve glucose utilization and thereby improve insulin sensitivity.29
No matter what your preferred form of movement or exercise, it is clear: inactivity can lead to insulin resistance. And movement increases insulin sensitivity as long as the exercise continues.30 So if you stop moving regularly, insulin resistance may come back.
One more thing on exercise: you likely cannot outrun a bad diet. Exercising regularly but still eating a high-carbohydrate, high-sugar diet will likely partially, if not completely, counteract many of the benefits derived from exercise.31
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How Does The Insulin Assay With Oral Glucose Tolerance Test Work
In a similar manner to the oral glucose tolerance test, the patient fasts overnight and then completes fasting blood work. The main difference is that at each interval during the 2 or 4-hour span of the test, insulin is measured along with glucose.
This provides great insight into patterns of insulin resistance. Not only can the fasting levels be checked, but increases in insulin production when stimulated by glucose are easily seen.
Causes of low blood sugar can be understood as clear patterns of hyperinsulinemia and reactive hypoglycemia are picked up by this test.
In addition, a phenomenon called gastric dumping can be determined through observing specific patterns in insulin release and glucose levels over the span of the test.
Can You Reverse Insulin Resistance
On the bright side, there are ways you can help improve insulin sensitivity and reverse insulin resistance:
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Engage in at least 30 minutes of physical activity most days of the week. Exercise is one of the fastest and most effective ways to reverse insulin resistance.
-
Lose weight, especially around the middle. Losing weight around the abdomen not only improves insulin sensitivity but also lowers your risk of heart disease.
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Adopt a high-protein, low-sugar diet. Protein helps keep your bodys blood sugar levels stable, whereas high-sugar diets can cause spikes in blood sugar that only make insulin resistance worse. Even though being insulin resistant doesnt necessarily mean you have diabetes, following a meal plan recommended by the American Diabetes Association can help improve insulin sensitivity.
Recommended Reading: The Mayo Clinic Diabetes Diet
What Questions Should I Ask My Doctor
If youve been diagnosed with insulin resistance, it may be helpful to ask your healthcare provider the following questions:
- Whats causing my insulin resistance?
- What can I do to increase my insulin sensitivity?
- Whats my risk of developing prediabetes or Type 2 diabetes?
- Is there any medication I can take?
- Should I see a specialist for insulin resistance?
A note from Cleveland Clinic
Insulin resistance is a complex condition that can affect your health in several ways. Since it doesnt have any symptoms until it turns into prediabetes or Type 2 diabetes, the best thing you can do is try to prevent and reverse insulin resistance by maintaining a healthy weight, exercising regularly and eating a healthy diet. Unfortunately, though, not all causes of insulin resistance can be prevented or treated. If you have any questions about your risk of developing insulin resistance or conditions associated with it, talk you your healthcare provider. Theyre there to help you.
Last reviewed by a Cleveland Clinic medical professional on 12/16/2021.
References
How Do I Know If I’m Insulin Resistant
Hereâs the problem. Most people who have insulin resistance donât know they have it.
One third of Americans have insulin resistance, according to the Centers for Disease Control . But four out of five people who have insulin resistance donât know they have it. While insulin resistance may cause symptoms in the early stages, such as low energy, many people will not notice symptoms. But that doesnât mean insulin resistance isnât causing damage in the body. The only way to know if you have insulin resistance is to test for it.
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Know More With Ir Testing From Quest Diagnostics
Quest offers the Cardio IQ® Insulin Resistance Panel with Score, a simple, accurate, and actionable way to assess IR and identify prediabetes and diabetes risk. Its the only routine insulin resistance score validated against the gold standard.
- Validated in a Stanford University study of 535 individuals without diabetes or cardiovascular disease3 against the insulin suppression test, a gold standard method for the direct measurement of insulin resistance
- Provides an enhanced assessment of IR through the combined measurement of insulin and C-peptide from a single fasting blood specimen
- Offers greater discrimination of IR compared to either insulin or C-peptide levels alone and a better assessment of IR status than TG/HDL or HOMA-IR3
- Detects IR and possible risk of prediabetes or diabetes before traditional markers can
Insulin Affects The Delicate Hormone Balance
LH is like the switch for ovulation: you can only ovulate when your LH rises steeply. However, researchers think that the ratio of LH to FSH is the thing thats really important for ovulation. Studies on PCOS have shown that insulin increases LH, damaging the LH:FSH ratio. Clomid is a drug which is given to many women with PCOS who are struggling to ovulate. Clomid increases FSH levels and re-balances the ratio.
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Hypocaloric Diet And Weight Reduction
Insulin sensitivity improves within a few days of caloric restriction, before any significant weight loss occurs.13 Weight reduction leads to further improvement. The amount of weight loss needed for sustained decreases in insulin resistance is still unclear. In obese women without diabetes, weight loss of approximately 15 percent has been linked to significantly lower insulin levels.22 Regaining even a modest amount of the lost weight, however, with a body weight that was still 10 percent below starting values, resulted in an increase in insulin levels to baseline. The women in this study were very obese and remained obese even with the loss of 15 percent of body weight . The implication is that all obese patients should be encouraged to attain a healthy body weight. This can be accomplished and sustained through dietary modification and exercisea recommendation that is easy to make, of course, but difficult to follow.
What Tests Will Be Done To Evaluate Insulin Resistance
Your healthcare provider may order the following blood tests to diagnose insulin resistance and/or prediabetes or diabetes:
- Glucose: A fasting plasma glucose or a glucose tolerance test may be used to screen for, diagnose and/or monitor prediabetes, type 2 diabetes or gestational diabetes.
- Glycated hemoglobin A1c : This test reveals your average blood glucose levels over the past three months.
- Lipid panel: This is a group of tests that measure specific lipids in your blood, such as total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.
Your healthcare provider may also order tests that can help diagnose other conditions that are associated with insulin resistance, such as metabolic syndrome, cardiovascular disease and polycystic ovary syndrome .
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How To Treat Insulin Resistance
The good news is that there is a lot of lifestyle changes you can make to improve or completely reverse your insulin resistance ultimately lowering your blood sugar levels.
Exercise Exercise is one of the most effective ways to reduce insulin resistance.
Eat a healthy diet Eat a healthy diet full of whole grains, fruits, vegetables, oily fish, nuts and seeds. Avoid having too much processed and sugary foods. You could also try intermittent fasting alternate between periods of fasting and periods of eating. Theres a number of ways to do this so its important to research this method of eating first and speak with a health professional.
Avoid smoking If you smoke, quitting can really help to reduce your insulin resistance.
Get enough sleep
How Is Insulin Resistance Diagnosed
Your doctor will ask you questions about your symptoms, your personal and family medical history, evaluate your weight, and take your blood pressure. Diagnosing insulin resistance requires a blood test. This might be done through a small finger prick or by having a small needle inserted into a vein to take a sample of blood. You will often be required to fast 8 hours before the test. The blood sample will be sent to a lab for testing. It will test your fasting blood sugar. Anything more than 100 mg/dL is an indication of insulin resistance. Your doctor also may have the lab check your cholesterol levels . People with insulin resistance often have high cholesterol.
The American Academy of Family Physicians recommends blood glucose screening of all pregnant women for gestational diabetes after the 24th week of pregnancy. Also, the AAFP recommends blood glucose screening for adults age 40 to 70 years who are overweight or obese and may be at risk of heart disease.
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