Insulin Resistance Made Simple

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HOW DOES INSULIN WORK?

Your body makes insulin molecules and insulin receptor molecules to help move glucose (sugar) molecules into your muscle, fat, and liver cells. The insulin is made in the pancreas by beta cells. The insulin receptors are made by the muscle, fat, and liver cells and are located on their outer cell membranes.

Think of insulin being like a ship unloading its cargo in a harbor. The cargo is glucose.

The pier where the ship is moored is the insulin receptor located on the outer cell membrane.

In the healthy metabolic state, the ship sails calmly into the harbor, docks, unloads its cargo, undocks, and sails calmly out of the harbor.

The following diagram shows how this actually happens in the body with insulin acting like a key opening the door for glucose to enter the cell (not like a ship).

(1) Insulin binds to the insulin receptor on the cell membrane. (2) This initiates several intracellular activities: (3) movement of Glut-4 transporter to the plasma membrane resulting in the movement of glucose into the cell, (4) glycogen synthesis, (5) glycolysis, and (6) fatty acid synthesis.

The following diagram and video also illustrate insulin’s action.

INSULIN RESISTANCE

In the unhealthy insulin resistance state, the seas are stormy, the ships are spilling their cargo, and fewer ships are able to dock and successfully unload their cargo at the pier. More and more ships are necessary to get the much needed cargo unloaded at the pier and the harbor becomes clogged with ships, ship wrecks, and cargo.

The following diagram shows insulin resistance at the cellular level.

Compared to the similar “normal cell” diagram above, you can see that insulin and glucose are accumulating outside the “insulin resistant cell” as insulin molecules are having a hard time binding to insulin receptors.

HYPERINSULINEMIA

When insulin resistance is present, the pancreas has to make more insulin than normal to process dietary carbohydrates. The excess insulin is referred to as hyperinsulinemia.

Hyperinsulinemia is associated with the following pathologic conditions:

1. Obesity
2. Hypertension
3. Atherosclerosis
4. Heart attack
5. Stroke
6. Deep Venous Thrombosis
7. Pulmonary Embolism
8. Gout
9. Polycystic Ovary Syndrome
10. Nonalcoholic Fatty Liver Disease
11. Sleep Apnea
12. Hypogylcemia
13. Type II Diabetes

WHAT CAUSES INSULIN RESISTANCE?

All of these possible causes are subject to ongoing debate in the scientific community:

1. Genetic factors
2. Consumption of Bad Carbohydrate (high glycemic index with vitamins, minerals, anti-oxidants, and fiber stripped by processing)
3. Consumption of Bad Fat (saturated fat, trans fat, and Omega-6 fats)
4. Consumption of Pro-inflammatory Foods (fast food and processed food)
5. Excess Caloric Intake (even if 100% “healthy” calories)
6. Lack of Proper Exercise
7. Stress
8. Tobacco Smoking
9. Excess Caffeine Intake
10. Excess Alcohol Intake
11. Pregnancy

THE DIAGNOSIS OF INSULIN RESISTANCE

Step Number One: MEASURE YOUR WAISTLINE!

An above normal waistline measurement is the most reliable indicator of insulin resistance. Guidelines for what represents a normal waistline is in constant debate but a good reference is the following table from the International Diabetes Federation (click on the pdf link below).

waistline_download_pdf

The following video provides excellent information regarding your waistline measurement.

Scientific research is revealing a growing number of ways that excess fat negatively influences our health. Just like the pancreas produces insulin, fat produces a number of hormones and inflammatory molecules that affect metabolism, appetite control, reproduction, and other bodily functions. The more fat you have around your midsection, the more negative the effect of fat on your health.

Japan has launched a controversial nationwide campaign to trim their population’s waistline.

http://www.nytimes.com/2008/06/13/world/asia/13fat.html?pagewanted=all

Step Number Two: BEGIN A BLOOD PRESSURE DIARY!

Very accurate home blood pressure (BP) monitors can now be purchased at very reasonable prices. Spot check your BP once a day being sure to vary the time. A systolic BP greater than or equal to 130 and a diastolic BP greater than or equal to 85 are both associated with insulin resistance.

A higher BP on waking than when going to sleep is a sign of sleep apnea.

Also check your BP if you become angry or anxious and if you eat a highly processed meal. BP spikes are associated with an increased incidence of stroke and heart attack.

Step Number Three: CHECK YOUR TRIGLYCERIDE AND CHOLESTEROL LEVELS!

A triglyceride level of greater than or equal to 150 mg/dl is associated with insulin resistance.

An HDL cholesterol (the good kind of cholesterol) level of less than or equal to 40 mg/dl for males and 50 mg/dl for females is associated with insulin resistance.

Step Number Four: CHECK A FASTING PLASMA GLUCOSE LEVEL!

A fasting glucose level of greater than 100 mg/dl is associated with insulin resistance.

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