Ins-and-outs of Insulin Resistance

Insulin resistance seems to be the new “buzz word” and is a hot topic of conversation. It is widely blamed for higher incidence of overweight and obesity and yet the general understanding of the concept appears slightly hazy. Staying true to the topic of our blog series, let’s clarify the current controversy…

So what is insulin resistance?

Before we delve into the ins and outs of insulin resistance, let us first clarify the concept of insulin itself. Insulin is a hormone secreted by the pancreas. Its role is to help glucose being transported in the blood, to successfully enter the cells of the body. Glucose is necessary for energy release and can either be used immediately or stored, for later use, in the liver or muscle cells as glycogen.

 Insulin resistance thus follows as a condition where intricate cell receptors fail to respond properly to the insulin hormone and glucose is not transported effectively into the cell. Problems in the receptor mechanisms have been associated with excess abdominal adiposity and high saturated fat and refined carbohydrate intake. The phenomenon is often explained by the “lock and key” theory, where insulin is the key and the cell wall is the locked door. There is a problem with the key not fitting the lock and as such the door cannot open to allow glucose in. Due to the delay of glucose transport into the calls a physiological response is mounted by the body. The pancreas overcompensates to produce more insulin in an attempt to overcome the resistance of glucose uptake into the cells. The result is high levels of circulating glucose that cannot enter the cell – high blood sugars – as well as a raised level of insulin in the blood.

Sufferers of insulin resistance may feel dizzy and lacklustre and as such a common pitfall is reaching for a quick energy meal or a snack. Often these comprise of simple, refined sugars which only exacerbate the problem further. Another surge of sugar into the blood, coupled again with the unsuccessful sugar uptake into the cell results in rollercoaster sugar levels fuelling increased hunger pangs and swinging spells of exhaustion.

 Insulin resistance of the cells can lead to a variety of serious health disorders, and can result in metabolic syndrome or insulin resistance syndrome. This, however, is not a disease but a cluster of metabolic abnormalities associated with an increased risk of cardiovascular disease and type 2 diabetes.The following criteria for diagnosis have been proven, and if an individual has three or more of the symptoms, the person is can be diagnosed with insulin resistance syndrome. It is important to note that only a healthcare professional can diagnose this syndrome.

• Abdominal obesity (waist circumference for men > 94cm and for women >80cm);
• Raised triglycerides (>1.7mmol/l);
• Reduced HDL cholesterol (<1.03mmol in men or <1.29 mmol/l in women);
• Raised blood pressure (systolic >130mmHg; diastolic >85mmHg); or
• Raised fasting plasma glucose (>5.6mmol/l)

 Insulin resistance syndrome is no “new kid on the block” and in fact has been used in the medical and nutrition fraternities for a number of years. It is important to view this syndrome as a representation of a cluster of other markers, namely: increased waist circumference, abnormal lipid profile, raised blood pressure and abnormal glucose control. Naturally, with a number of factors being involved, the solution is multifaceted and must involve a combination of both dietary and lifestyle changes, not one “magic” quick fix.