Insulin Resistance

 
     We have known about insulin resistance for a long time now.  It has started to become a trendy marketing term to promote some supplements and eating plans.  I'll discuss what it is, what it does, and how to reduce it or eliminate it.  Insulin Resistance is not a disease, but a hormone abnormality that occurs due to genetics, diet, lack of exercise, smoking, and body fat percentage.
 
     There are usually no symptoms associated with this problem.  It occurs when our body is no longer as sensitive to the effects of the hormone insulin and has difficulty processing glucose (sugar) levels in our body.  It is in fact a syndrome with another name,  Metabolic Syndrome.  As a Doctor, we are trained to be able to tell if someone is most likely insulin resistant just by looking at the person and maybe a few simple measurements.
 
     As we become more resistant to our own insulin, our blood sugar starts to elevate.  In response to this, our pancreas produces more insulin to keep the blood sugar within a tight range.  As the amount of insulin goes up in our blood, it has several negative effects on us.  It causes us to make fat, store fat, and to be more hungry.  When we eat more food our blood sugar goes up and we make more insulin resulting in more body fat production.  The cycle continues until treatment is undertaken or end stage disease occurs.
 
     Insulin is a hormone or messenger made in the Beta Cells of our Pancreas.  It tells our muscles, liver, brain, and other tissues how to utilize glucose, our fuel.
When the balance between glucose levels and insulin production gets out of line, our body develops significant metabolic problems and these problems in turn worsen the resistance to our insulin.
 
     How does one know if they have or are developing insulin resistance?  First, measure your waist.  If it is larger around than 40 inches in a man or 35 inches in a woman, that's a very strong sign of insulin resistance.  Too much belly fat tells the story.  Other findings associated with insulin resistance include elevated blood pressure readings, elevated fasting blood sugar, high fasting triglycerides, low HDL (good type cholesterol), Skin tags, patches of acanthosis nigricans on the neck, underarms, groin, or face and trouble losing weight.
 
     Left alone without treatment, insulin resistance will lead to further obesity, diabetes, abnormal lipids, high blood pressure, cardiovascular disease, heart attack, stroke, and premature death.  It is imperative to diagnose and treat this hormonal disorder.  This disorder can be reversed.  It takes a proper treatment plan that includes, weight and body fat reduction, regular physical activity up to 150 minutes of moderate exercise weekly, smoking cessation, Carbohydrate reduction, and in many cases medication.
 
     Medications for Insulin resistance include Metformin, GLP-1 agonists (promoters),  and possibly weight reduction medications to enhance body fat reduction.
 
     Since this is a genetically based disorder, if a family member is obese or overweight, has diabetes type II, has high blood pressure, elevated fats in the blood, and seems to have an apple type body shape with a large belly in proportion to their extremities, you could be a candidate for this disorder too.
 
     Treatment of Insulin Resistance requires body fat reduction.  It also includes working up to moderate exercise to 150 minutes a week.  Medication can initially be used, but if weight comes down and exercise goes up, many times this disorder can be put into remission.  If a high carbohydrate, high calorie diet is resumed, insulin resistance will return.
 
     This condition is epidemic in our society today.  The rapid rise of Diabetes Type II, increasing rates of heart disease, and a population of hypertensive and hypercholestolemic patients attests to this.
 
     Today, measure your waist at your belly button.  If it's over 40 inches for a man or 35 inches for a woman, it's time to get more testing done.  Some simple blood tests will tell the story, and your doctor can work with you to reverse and control this future life-threatening problem.
 
     Getting our insulin levels to a very low number and keeping our fasting blood sugar in a range from 70 to 99 can allow us to avoid the downside of aging and reduce the need for blood pressure, cholesterol, triglyceride, and diabetes medications as we get older.  There is no magic to reversing insulin resistance.  It takes knowing your numbers and working on a proper diet, adequate exercise, and eliminating the bad habits of health in our lives.
 
     There is no time like today to start this journey toward a healthy long life.

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