In 2021, there were around 537 million adults (20-79) living with diabetes. It is expected that by 2030, the number will rise to 643 million and 783 million by 2045. Additionally, around 4 million people die annually from diabetes (1).
Interestingly, although our genes partially control it, other factors play a role, too. The major part of diabetes is controlled by our diet and lifestyle. So imagine that one of the most common diseases on earth is controllable only through diet and lifestyle.
There is a link between insulin resistance and several lifestyle-related issues. For instance, obesity accounts for 80% of the risk of developing insulin resistance! (1). Additionally, several studies found that smoking was associated with a 37% increased risk of developing insulin resistance compared with non-smoking (2).
If not managed well, insulin resistance can lead to fatal complications like eye problems, kidney failure, nerve problems, heart disease, hypertension, and cardiovascular disease.
Clearly, we are facing an issue. Diabetes is not just a disease; it is an epidemic.
There are two types of diabetes: type 1 and type 2. Type 1 is common among children.
The average age of diagnosis is 13 years. Nevertheless, the average age of diagnosis of type 2 is 45 years.
Type 1 occurs due to insulin deficiency rather than insulin resistance, which is seen in type 2 diabetes.
Therefore, we will focus primarily on insulin resistance and type 2 diabetes, but we will also touch on type 1 diabetes.
It is a summer day, and your body feels hot and weary. You decided to order a vanilla ice cream. You now get the rush of sugar into your blood, and you feel energetic once again.
Have you ever wondered how this sugar, also known as glucose, goes into your cells? You might think that it is straightforward: it just enters our cells. Unfortunately, it is so much more complex than you ever think.
When blood glucose levels in our blood rise, this signals our pancreas (an organ that sits in our abdomen) to start releasing a crucial hormone known as insulin. Specifically, a group of cells known as beta cells is responsible for secreting insulin.
Insulin acts like a key that opens a gate in our cells to allow glucose to enter the cells.
Once insulin is secreted, it opens the gate that allows glucose to enter.
These gates are specific channels, known scientifically as GLUT.
Once GLUT is produced by our cells and is put on the cell membrane, glucose enters through the GLUT channel.
If GLUT does not exist, glucose will keep hanging out and be unable to enter our cells.
The exact mechanism by which insulin leads to the activation of the GLUT gates is way more complex and beyond the scope of this post but that is a small summary of what happens to help one understand what happens.
All you really need to know is that insulin acts as a key that opens the door for glucose to enter our cells.
Insulin resistance develops when our cells no longer respond to insulin.
In other words, you are no longer insulin sensitive. Insulin sensitivity indicates better responsiveness, and insulin resistance is fundamental for developing type II diabetes.
But wait, what makes us insulin resistant then? What are the risk factors for insulin resistance?
Is insulin resistance the same thing as type 2 diabetes, or maybe it is a stage of it? Let’s see.
As explained above, insulin resistance is multifactorial, and many factors like age, health, diet, exercise, smoking, and genetics play a huge role.
Among these risk factors, obesity seems to be the most important one.
Obesity leads to insulin resistance in several ways.
But first, let’s understand the two types of obesity: visceral and subcutaneous obesity.
Obesity means extra fat deposition. But it depends on where this fat is deposited.
If the fat is deposited underneath your skin, this is called subcutaneous obesity.
Visceral fat lies deeper and wraps our intraabdominal organs.
Some studies have found that visceral obesity is associated with a higher risk of insulin resistance, diabetes, heart disease, hypertension, and stroke.
Visceral obesity leads to insulin resistance because it has been shown to secrete a protein called retinol-binding protein 4 (RBP4), associated with insulin resistance (3).
Additionally, visceral fat secretes excess fatty acids that can interfere with the intracellular mechanisms of insulin, leading to insulin resistance.
But how can you know if you have visceral or subcutaneous obesity? It is simple.
People with visceral obesity tend to have an apple-shaped body, while those with subcutaneous obesity tend to have a pear-shaped body.
Another measure that can help you is waist circumference. A consensus on the cut-off points for high risk for metabolic complications (e.g., insulin resistance, heart disease, stroke) is > 102 cm in men and > 88 cm in women.
The story of obesity is not over here. Chronic obesity and increased lipid levels in the blood can lead to fat deposition within the skeletal muscles.
Our skeletal muscles play a huge role in storing glucose and lowering blood glucose levels.
The excess fat deposition impairs glucose metabolism and insulin action within the muscles.
This can happen in many ways. First of all, fatty acids excess is toxic and can induce a state of inflammation that promotes insulin resistance.
Also, excessive fat can plug the insulin receptors, making insulin unable to access its receptor and cause its action. The overall effect of this is insulin resistance.
Here’s a list of the essential elements associated with an increased risk of insulin resistance.
- Positive family history
- Race/ethnicity (Hispanics, African Americans, Native Americans, Asian Americans, and Pacific Islanders.)
- Physical inactivity
- Hyperlipidemia (an abnormally high concentration of fats or lipids in the blood)
- History of gestational diabetes
Now you may wonder, what is wrong with having excess blood glucose?
Why is this considered a bad thing?
While acutely elevated blood glucose is not a problem, chronically high glucose levels can be fatal in the long term.
Chronic insulin resistance may lead to type 2 diabetes. Therefore, think of insulin resistance as an early stage of diabetes.
The problem is that excess glucose in the blood can react with proteins that line our blood vessels and other proteins in the body, leading to the formation of toxic substances.
These toxic substances are enhanced in diabetics.
This is when complications of diabetes such as aging, chronic kidney disease, atherosclerosis, and more can arise.
We can arrange insulin resistance and diabetes complications into two categories: microvascular and macrovascular.
Microvascular means damage to the small blood vessels, while macrovascular means damage to the large blood vessels.
When small vessels are affected, this can lead to complications in the following organs: eyes, nerves, and kidneys.
However, when large blood vessels are damaged, this can damage the brain (leading to stroke) and the heart (leading to heart attack).
Microvascular means damage to the small blood vessels. These blood vessels become thickened and unable to deliver blood to the sense organs like the eyes, nerves, and kidneys.
This can lead to the following complications:
Retinopathy is damage to the blood vessels of the retina, which is the back of the eyeball and the area responsible for perceiving objects.
In retinopathy, the blood vessels are damaged, leading to hemorrhages and aneurysms (dilation of the blood vessels).
When the retina is damaged, this can lead to blindness if not diagnosed early and treated seriously.
Symptoms include worsening vision, blurred or patchy vision, eye pain or redness, and difficulty seeing in the dark.
Diabetic neuropathy means damage to the nerves due to compromised blood supply. When nerves are damaged, this leads mainly to sensory problems, which means that the sensation is impaired due to the damaged nerves.
This usually happens in the feet. Consequently, affected adults develop foot ulcers because their feet are chronically under trauma, and they are unable to protect because they just can’t feel the trauma.
Diabetic nephropathy is damage to the blood vessels supplying the kidneys. This will lead to kidney failure in the long term, and affected individuals will have to undergo chronic dialysis or do kidney transplant surgery.
As in microvascular complications, macrovascular complications are just damage to the large blood vessels that supply different organs.
This usually affects two organs: the brain and the heart.
This happens because insulin resistance and hyperglycemia lead to atherosclerosis of the blood vessels, which means they thicken.
This thickening compromises the blood supply leading to damage to the affected organs.
Unfortunately, stroke and myocardial infarction are severe complications associated with an increased death rate.
This is why insulin resistance is such a dangerous thing.
How To Reverse
Alright, we now know that insulin resistance is no walk in the park – It is a serious condition that could have potentially lethal outcomes.
With this in mind, one question comes up – Is insulin resistance reversible?
And well, the short answer is yes!
But how exactly can one do that? Let’s find out!
Believe it or not, for every sedentary day you spend, it should be compensated by 40 minutes of moderate to intense exercise.
Therefore, physical activity and regular exercise are the cornerstones of reversing insulin resistance.
This happens for many reasons.
First of all, the exercise by itself stimulates your skeletal muscles to produce the channels responsible for promoting insulin uptake (GLUT, remember them?).
Exercise can transiently lower your blood glucose.
Additionally, when you exercise regularly, you will lose fat. As we already learned, excessive fatty tissue is the most critical risk factor for developing insulin resistance.
It impairs the activation of insulin receptors and even plugs them, making insulin unable to do its job.
Aerobic exercise (Ex. Jogging) can increase insulin sensitivity as a 30-5 minutes session for 3-5 days.
Improvement can also be seen after a week of aerobic training with two short sessions of 25 minutes of walking.
Conversely, activity restriction reduces insulin resistance in as little as three weeks (7).
Additionally, note that aerobic exercise enhances insulin sensitivity regardless of weight loss.
Anaerobic exercise (Ex. Weightlifting) has been shown to enhance insulin resistance due to increased muscle mass.
The idea here is that more lean mass (muscle mass) leads to enhanced uptake since muscles are the major contributors to glucose uptake (8).
The idea that aerobic and anaerobic exercise can enhance insulin resistance and reverse diabetes was proven in countless research papers.
Therefore, it is highly recommended that you start with any of them and keep doing slight lifestyle modifications on the run.
It is not over yet. There are other interventions that you can do to reverse insulin resistance.
The most important of them is diet. You have no idea just how important this is for the overall quality of life!
It doesn’t only impact our health in general, but it even affects our mood and how we feel.
There is even a complete branch of science called “Nutritional Psychology” that mainly addresses this topic!
With no proper diet, you may not be able to control insulin resistance.
An increase in insulin secretion is noted with the administration of these supplements:
- Cocoa Extract
- Vitamin D
If you are wondering whether or not there are certain dietary approaches that lower insulin resistance, the answer is yes!
Here are the two most popular.
The paleolithic diet (Paleo)
A Paleo diet can decrease insulin resistance. Nevertheless, the effect may not persist beyond six months. Therefore, it should be combined with other interventions like exercise.
20:4 intermittent fasting
Similar to paleo, intermittent fasting can improve insulin resistance, especially when the feeding windows occur early in the day.
Besides supplements that increase insulin secretion, there are also certain products that enhance insulin sensitivity.
Let’s have a look briefly.
- Green tea catechins
- Chlorogenic acid
Resveratrol and carnitine may act directly on cells and increase insulin sensitivity, while green tea catechins and chlorogenic acid may inhibit or delay carbohydrates absorption.
Last but not least, there are also food products that can make insulin resistance way worse.
And so, if you are looking to improve your condition, do stay away from these foods:
- Processed foods
- White bread, rice, and pasta
- Fruit-flavored yogurt
- Sweetened breakfast cereals
- Fast food
- Packaged snack foods
- Foods rich in saturated and trans fats (like red meat and dairy products)
- Sweetened drinks, like fruit drinks, soda, and ice teas
You shouldn’t underestimate insulin resistance. It is real, and if left uncontrolled, it can lead to diabetes and other fatal complications like blindness, foot ulcers, kidney failure, stroke, and heart attacks.
Insulin resistance usually occurs as a result of unhealthy lifestyles that are associated with obesity and sedentary life. You may also consider a detox to rid your body and blood of harmful toxins that can keep your body from healing.
Obesity is one of the most critical risk factors for insulin resistance and diabetes.
Although you shouldn’t underestimate insulin resistance, you shouldn’t be afraid of it as well.
Many interventions like aerobic and anaerobic exercise are shown to be effective in reversing insulin resistance in some people.
Additionally, there are many supplements that you might want to consider that will enhance your glucose metabolism and improve insulin sensitivity.
Always remember to consult with your doctor before taking any supplements or starting any health regimen.