Insulin Resistance

Insulin resistance is a term that came into being in the last decade. A professor of medicine at Stanford University named Gerald Reaven was the first scientist to identify those individuals with a conglomerate of symptoms that he coined “metabolic syndrome” or “syndrome X” since there was no specific name for individuals with these specific symptoms.

Normally insulin, a hormone released from the pancreas, enables cells to remove glucose (sugar) from the blood stream to be used as energy. Approximately 25%-30% of the population inherits a resistance of their cells to respond properly to insulin. This results in higher circulating levels of blood glucose, which causes the pancreas to release ever-increasing amounts of insulin in an attempt to normalize blood glucose levels. This state of high circulating insulin is termed hyperinsulinemia.

Hyperinsulinemia (also known as Syndrome X) is associated with a number of pathologic (disease-producing) consequences including high blood pressure, weight gain, elevated cholesterol and triglycerides levels, diabetes, and heart disease. Some individuals have traces of insulin resistance without the other symptoms. There is approximately a 1000 fold variation of insulin resistance in any one individual. Some people can have traces of insulin resistance and others have a high level of resistance, which can eventually lead to adult diabetes. Since it is so poorly understood no cure has been found. However, specific diet therapies exist to assist in dramatically lowering insulin resistance and allow an individual to lose weight. There are also several medical drugs available for with more advanced cases of insulin resistance that assist with lowering insulin resistance.

Factors that contribute to insulin resistance are a sedentary lifestyle, a family history of high blood pressure, diabetes, heart disease, a history of gestational diabetes, a diagnosis of high blood pressure, elevated triglycerides/low HDL-cholesterol levels, or heart disease, and a fasting glucose level of greater than 110 mg/dL.

Once only seen in adults, we are seeing children as young as 7 years old with metabolic syndrome, and many teens 11-17 with insulin resistance/metabolic syndrome leading to adult diabetes.

Daily exercise can dramatically assist in lowering insulin resistance by as much as 35-50%. According to Glen Gaessar, Ph.D., a professor of kinesiology at the University to Virginia, “changing either weight or exercise patterns can have profound effects. Exercise is essential because muscle is the biggest tissue in the body – 30 to 40 percent of body mass is muscle. It’s the major site of glucose disposal. Inactive muscle is not as sensitive to insulin.” Most exercise physiologists recommend daily exercise since a person is most insulin resistant in the morning. Daily morning exercise can dramatically lower insulin resistance for that day. However, exercise at any time is also very helpful. Even moderate levels of exercise (such as walking) are very powerful in lowering insulin resistance, leading to weight loss.

A diet that is moderate in carbohydrate and contains greater amounts of protein and monounsaturated fats at each meal can also be helpful in lowering symptoms associated with insulin resistance. Seeking the help of a R.D. who specializes in treating insulin resistance is essential since following a low calorie diet is not helpful in the long term with insulin resistance and can lead to eventual weight gain.

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