Obesity has become an epidemic in the United States, and with it, rates of diabetes have soared. Today in the U.S., 24 million people have been diagnosed with Type II diabetes, and it has been projected that some 57 million more individuals are “pre-diabetic.” Though it is possible to have this syndrome and have a normal BMI (body mass index), diabetes and obesity have become so commonly linked that the combination of conditions has come to be referred to as “diabesity.”
Diabetes has a continuum of symptoms, starting from an early diagnosis of “pre-diabetes” in people who do not yet have the condition but exhibit precursors of the disease. “Normal” diabetes, or what we generally think of when referring to the disease, is glucose intolerance. But for some, particularly those who are both diabetic and obese –- in other words, patients with diabesity — insulin resistance can emerge as a major health problem.
Insulin is a hormone that controls metabolism by supplying cells with energy and regulating blood sugar. If you’re healthy, the food and drink you take in are converted to sugars that enter your blood stream, triggering your pancreas to produce insulin. Insulin is like a “signal” to your fat and muscle cells, which use sugars the most, that it’s time to absorb sugar. These sugars then leave the blood, causing your blood sugar level to drop and insulin production to turn off. Eating again stores it right back up — that’s why eating a piece of fruit or a handful of nuts when you feel groggy in the afternoon can make you feel like you have more energy. It’s just basic, healthy metabolism.
Insulin and blood sugar levels can be well maintained with good nutrition –- think lots of whole, unrefined foods including organic lean meats, fruits, and vegetables. Overly refined foods -– like alcohol, sugars, soda, and starches –- are quickly turned into sugar leading to a rush of insulin. That’s why if you eat a candy bar or have a soda for that same groggy feeling, even if you initially feel jazzed up, you’ll soon find yourself experiencing a “sugar crash.” Poor diet, especially combined with little exercise, is strongly implicated in insulin resistance — another reason for the link with diabesity.
For those who suffer from diabesity and experience insulin resistance, things aren’t so simple. In people with insulin resistance, the body doesn’t recognize that insulin is being sent out. The fat cells are not getting glucose, and the body believes the cells are starving, leading to fat accumulation in different areas of the body (particularly the flanks, love handles, and around the shoulder blades). While this is going on, the body continues to send out larger and larger amounts of insulin, to the point where the “signal” no longer works. Blood sugar levels can go higher and higher, but it has nowhere to go.
The most common features of insulin resistance are obesity (especially with a high concentration of fat in the abdominal region, or having a “pear-shaped” body), high triglyceride levels, hypertension (high blood pressure), and elevated blood sugars. Insulin resistance can be associated with symptoms like fatigue; sugar or carb cravings; erratic or insatiable appetite; weight gain or difficulty losing weight; insomnia; frequent illnesses; decreased memory, mental clarity, or attention; headaches, sluggishness after eating; and menstrual irregularities. It can also have more subtle and sometimes surprising symptoms, too. For example, skin tags, hirsutism (hair growth) in women or hair loss in men, adult acne, acantharis nigricans (dark patches in the folds of your skin in the underarms), fatty liver, and ketosis pilaris (bumps on arms).
Insulin resistance more importantly causes an inflammatory state that damages the cells and even the DNA throughout the body. It is one of the main contributory factors of all chronic diseases (not just diabetes) including heart disease, Alzheimer’s, rheumatic diseases, and many more; and it leads to advanced aging. Insulin resistance contributes to the well-described metabolic syndrome that is associated with increased abdominal girth, high triglycerides, elevated blood pressure, elevated blood sugar, and reduced HDL (good cholesterol). Metabolic syndrome has been linked to an at least doubled risk of heart attacks and strokes.
Insulin resistance can be caused by a number of other factors, not just obesity (though it is a common cause). Contributing factors can include oxidative stress, chronic stress, food allergies, toxins, adrenal dysfunction, gut dysbiosis, hormonal imbalances, nutritional deficiencies, infections, methylation defects, lack of sleep, and even some pharmaceuticals, particularly statins and anti-hypertension drugs. There are also some chronic conditions that are associated with having high insulin levels regardless of your weight — for example, PCOS, a fatty liver, thyroid problems, inflammation, Cushing’s/Addison’s disease, and breast or colon cancer.
Not all patients who have insulin resistance will develop diabetes. Insulin resistance can itself wreak havoc in our bodies while going undetected by standard tests for diabetes. In many cases, people do not realize they are experiencing insulin resistance until it has progressed to diabetes. To ensure that you are not running this risk, you can come in for diagnostic tests that can help assess your risk. First, checking your fasting glucose and insulin levels is key (people suffering from diabetes will have higher levels even without having eaten). Hormonal imbalances such as elevated cortisol or leptin can be also assessed, since these can also worsen insulin resistance. Deficient levels of growth hormone and DHEA may also exacerbate insulin sensitivity. Markers of inflammation caused by the insulin resistance can also be checked. Nutritional levels in Vitamin D, zinc, and magnesium need to be looked at since they play a big role in glucose metabolism. Lastly, food allergy testing can also be done for those for whom food intolerance is suspected of driving the insulin resistance.
You can also work to make lifestyle changes now that can have a positive effect on your long-term health. Nutritional research has shown promising results with supplements including magnesium, CoQ10, alpha lipoic acid, vitamin D, omega 3, selenium, chromium, cinnamon, fenugreek, bitter melon, resveratrol and grape seed extract. Eating a healthy diet, and reducing your toxins, can be a major boost. Exercising and reducing stress –- always easier said than done, but excellent options — can also help reduce your risks.
Want to learn more about insulin resistance, or get tested? Call (408) 740-5320 today to make an appointment to come in and talk with Dr. Tang! You can also learn more about the vitamin testing and high-quality nutritional supplements that Rejuvé has to offer.
