Have you been diagnosed with insulin resistance, pre-diabetes, or even diabetes?
Even if you haven't been diagnosed with insulin resistance, there is a good chance that you have it and don't even know it.
Insulin resistance is primarily a dietary disease - what you have been eating has played a major role in causing you to have this condition.
The good news is that by changing what you eat and how you live, you can make major strides in reversing this condition.
In this article I'm going to discuss a comprehensive approach on how to treat insulin resistance.
This will include a proper diet, activity level, supplements, medications, and much more...
In order to understand insulin resistance, it's important to understand what insulin is and what is does NORMALLY in the body.
Insulin is a hormone that is secreted by the pancreas.
When we eat a meal that contains glucose (sugar), the pancreas is signaled to secrete insulin into the bloodstream.
The insulin will attach to the sugar and move it into the cells where the sugar can be used as fuel for energy.
It also moves the sugar into fat and liver cells where it is stored to be used for fuel at a later time.
That is how things should work.
With insulin resistance, things get messed up.
When we eat too much sugar (which is most people in the US), the cells get bombarded with so much sugar that it can be toxic to the cells.
To protect the cells from this toxic load of sugar, the cells downregulate the insulin receptors.
In other words, they reduce the number of channels that the insulin can use to enter the cells, kind of like locking several of the doors that go into your house.
The results? Insulin is not as effective, so the pancreas releases even more of it and the blood sugar level gradually increases.
The process gradually worsens over time. Your insulin and blood sugar levels continue to rise until someone checks your blood sugar and diagnoses you with pre-diabetes or diabetes.
Has this happened to you or someone you know?
The shocking part is this process is occurring right now in about 50% of the people in the United States.
This is an epidemic that must be addressed.
By the way, when discussing diabetes in this article, I am referring to Type II diabetes.
Type I diabetes is an autoimmune condition where the body's immune system attacks and kills the cells in the pancreas that produce insulin. Those folks therefore don't make enough insulin and must take insulin shots for the rest of their lives.
Insulin also does a lot of other really bad things as well.
It is one of the most inflammatory substances in our body.
Insulin causes cancer.
Insulin causes us to gain weight by increasing the size of our fat cells.
Are you beginning to see why it is so important to keep your insulin level as low as possible?
There are a few symptoms that can indicate that you may have insulin resistance.
There are also a few lab tests that are very helpful in diagnosing insulin resistance.
Ask your doctor to order these tests:
1. Fasting insulin level - should be < 5
2. Hemoglobin A1c - should be < 5.3
3. Fasting blood sugar - should be < 85
4. Possibly a 2 hour post-meal glucose level - should be < 120
If any of these labs are higher than these optimal levels, you have evidence of insulin resistance and you need to incorporate the treatment recommendations that I will discuss below.
It is critical to your long term health!
Now that we have identified that you have insulin resistance, let's discuss treatment options.
One of the biggest issues with treating diabetes is that the current treatment recommendations of many conventional medicine organizations focus purely on lowering blood sugar and do little to address insulin resistance.
A large part of their recommendations, especially in regards to diet, are obsolete. New research has shown that a lot of what we thought was true isn't anymore.
For example, the American Diabetes Association still recommends multiple portions of carbs from grains and other sources daily, then using insulin to keep the blood sugar levels low.
This is recommended despite that fact that studies show that simply lowering blood sugar levels has no benefit in reducing mortality. In fact, adverse events are actually INCREASED due to increased episodes of low blood sugar (hypoglycemia).
That is unfortunate because by the time the blood sugar is high enough to get the attention of most doctors, the insulin resistance has probably been around for quite awhile and has been causing problems.
Diabetes is really just advanced insulin resistance.
In my own practice, I had a patient that presented to my office complaining of uncontrolled diabetes with glucose levels running in the high 200s.
I put him on a whole food, low carb diet. However, he really didn't want to change his diet, so he requested that I send him to a certified nutritionist at a local hospital.
The nutritionist actually told him that he wasn't eating ENOUGH carbs and increased his carb intake substantially!
A month later, he called back to my office complaining that his blood sugar had gone up into the 400s!
That is why it is important that you do your homework and learn as much as you can about insulin resistance and how to reduce it.
You are in charge of you!
You will never lose weight unless you get your insulin resistance under control.
That is because when your insulin levels are high, your body is unable to burn your fat cells as a fuel source.
The burning of fat cells in the body is controlled by an enzyme known as hormone sensitive lipase.
This enzyme is inhibited by insulin.
Therefore, you MUST reduce your insulin level if you ever want to get the weight off.
Insulin resistance is also closely associated with leptin resistance which I discuss in this article.
If your leptin levels are elevated, it will be almost impossible to drop any significant weight.
Changing your diet may be the single more important thing that you can do when treating insulin resistance.
You will not have success if you don't change what you eat.
However, keep in mind that diet alone may not be enough to lower your insulin levels.
It is going to require a comprehensive approach involving everything we discuss in this article.
When deciding on what food to eat, ask yourself this simple question - Did God make this food or did man make it?
In other words, eat only whole, natural foods and avoid processed food.
Most vegetables are good. Try to stay away from starchy ones such as potatoes except on occasion.
When eating fruit, stick primarily with the berries and cherries. Also kiwi, lemon and limes.
Protein - chicken, turkey, fish (not tilapia), eggs, deli meats
Fat - coconut, avocado, olive oil, nuts and seeds (not peanuts), chia, flax
If you have insulin resistance, you need to avoid any foods that will be rapidly absorbed and are high in sugar.
There is a general rule that you should keep in mind: Eat when you are hungry and stop eating when you are full. Quit focusing on calorie counts and listen to your body.
One caveat to this rule. If you also have leptin resistance, it could affect your perception of hunger and you won't be able to trust what your body is saying to you.
Macros is short for macromolecules.
There are 3 macromolecules we talk about when discussing diet - carbohydrates, proteins and fats.
The conventional approach to treating insulin resistance is to just go "low carb."
However, carbs aren't the only macromolecule that can increase insulin levels.
Proteins also increase insulin production, so it is important that your diet be low in both carbs AND proteins.
That means you should eat a diet high in good quality fats.
Your ratios of these macros should be in these ranges:
You may need to adjust these ratios depending on what kind of a lifestyle you live.
If you have more muscle mass you may need more protein.
If you are extremely active, you may need more carbs.
Just make sure that most of your food comes from high quality fats.
If all of this seems overwhelming, you could consider one of these diets that have lots of online support, recipes and other information:
The one thing that is probably overlooked more than anything else when treating insulin resistance, obesity, and other conditions is fasting.
Going without food is probably the most effective strategy for lowering insulin and blood sugar levels.
And yes, when done correctly, it is safe and very effective in repairing your metabolism.
Fasting should be done in conjunction with diet, supplements, and even medication to work the best.
It is extremely important for you to know that fasting should NOT be done without physician supervision, especially if you are diabetic and are on a diabetes medication or insulin.
Fasting is so effective, it will drop your blood sugar which could potentially cause serious hypoglycemia.
Also, if prolonged fasting is used excessively, it can cause prolonged calorie restriction which can damage your metabolism and make insulin resistance worse.
In other words, fasting can be very effective when used correctly, but can be harmful when done incorrectly.
How does fasting work?
The longer you go without eating the lower your insulin levels fall.
Once your body uses up the majority of stored glucose in the liver for energy, it switches over to using the triglycerides that are stored in your fat cells.
You then start burning fat for fuel and your body becomes more sensitized to insulin.
There is one other important caveat that you should know:
Your adrenals and thyroid should be working optimally before trying intermittent fasting.
If you try fasting and you develop symptoms of dizziness, lightheadedness, tremors, increased thirst or urination, that may be a sign that your adrenals or thyroid are not working optimally.
Get them working well then you can try fasting again.
If you are ready to try fasting, start with this simple program:
- Start with a 14 hour fast
- Eat an early dinner
- Eat an early lunch around 11am the next day
- Repeat this twice weekly
Click here to read more from my article on intermittent fasting.
Exercise is very important in treating insulin resistance.
Now if you aren't exercising at all, doing anything is better than what you are doing now!
Simply taking a 15 minute walk will do wonders for your body and metabolism.
However, the best exercise for insulin resistance is High Intensity Interval Training (HIIT). Studies show that it helps sensitize the body to insulin.
It sounds complicated but it's not.
HIIT focuses on doing small bursts of all-out, maximum effort for 30 seconds followed by 60-90 seconds of moderate exercise.
This is repeated 5-10 times in a single session at least once per week.
This can be done while walking, on a treadmill, regular or stationary bike, rowing machine, etc.
Doing HIIT training for 10 minutes is more effective than just walking on a treadmill for 30.
Cortisol plays a big role in insulin resistance.
If you are under stress, your body will increase cortisol production. The cortisol decreases your body's sensitivity to insulin which makes insulin resistance worse.
This is true for chronic stress but also acute stress.
That is why it is essential for you to develop some healthy stress reduction habits if you want to decrease your insulin resistance.
These can include yoga, prayer time, good sleep, and fun hobbies.
It may also mean changing jobs or avoiding toxic relationships.
Just think of the word "balance." We need balance in every facet of our lives. Without it, we will start breaking down physically, emotionally, and mentally.
There are a few supplements that have been shown to improve insulin resistance.
Only taking these supplements will not get rid of your insulin resistance.
However, they are another tool in your toolshed that when used with the diet and lifestyle changes we have discussed can be very helpful.
The best supplements for reducing insulin resistance include (click on each for my recommended brand):
Unfortunately, many people with insulin resistance may need to consider medication, especially when it is advanced.
The diet, lifestyle changes, and supplements may simply not be enough to lower their insulin levels.
With that in mind, you have to be VERY careful about which medications you should use.
Remember, as a general rule, conventional medicine is more focused on lowering blood sugar levels than reducing insulin levels.
In fact, many prescription medications lower blood sugar by INCREASING insulin levels!
When insulin resistance is the cause of the elevated blood sugar, why would we use a medication that worsens the insulin resistance?
It makes no sense.
The good news is there are several medications that actually lower BOTH the blood sugar and insulin levels.
As an added bonus, they typically cause some weight loss as well.
Compare that to other medications including insulin that result in significant weight GAIN.
I'm not going to go into great detail about the "good" medications for insulin resistance, but I will list them below.
If you and your doctor determine that your insulin resistance is bad enough to merit using a medication, you should consider using one of these:
Each of these medications have their own set of precautions and contraindications, so make sure that you and your doctor discuss them thoroughly and monitor for any potential side effects or problems.
Insulin resistance is an extremely common and dangerous condition, affecting up to 50% of the US population.
Untreated, it can lead to pre-diabetes and ultimately Type II diabetes.
It will be almost impossible for you to lose weight until you reduce your insulin resistance.
Diet is a crucial part of managing insulin resistance.
Lifestyle interventions such as exercise and stress management are also critical.
Supplementation can help and prescription medication will often be needed, at least for awhile.
Incorporating ALL of these modalities will be necessary for you to have success in reducing your insulin resistance.
Now it's your turn...
Do you have insulin resistance?
What helped you to lose weight and reduce your insulin levels?
What advice do you have for others in your situation?
Leave your comments below.
Dr. Whelchel is a family physician who specializes in functional medicine, especially hormone optimization. He has over 20 years experience in private practice managing patients with various medical issues. His passion is helping patients reach their full potential of wellness and quality of life. He grew up in the Texas Panhandle where he currently lives. He is married and has 3 awesome children.