Insulin Resistance
Insulin resistance and type 2 diabetes which was once called Adult Onset or delayed onset diabetes as it was thought of as an ageing disease.
In the last few years it has been discovered that the cause of it is not ageing but obesity. Not necessarily BMI but more specifically fat around the waistline and visceral fat around the organs.
So what is insulin resistance exactly?
Insulin resistance occurs when your muscle cells, fat cells and liver cells don’t respond well to insulin and won’t easily allow glucose into the cells for energy. Your pancreas then makes more insulin for the same amount of glucose. This can cause blood sugar levels to rise.
Especially when large amounts of sugar are consumed. This is inflammatory to
the body.
The same insulin resistance also occurs with Leptin which is hormone that is secreted by the fat cells to signal that you have eaten.
This can create a double edged sword whereby your body doesn’t use glucose well but the Leptin signal is also blunted which will lead to overeating and a greater glucose load and therefor a greater secretion of insulin.
Insulin does 2 things;
1. It helps cells to absorb glucose.
2. It can trigger the conversion of glucose to fatty acids in the liver.
This can then lead to fatty liver, increased cholesterol, raised blood pressure, kidney damage and eventually type 2 diabetes and heart disease.
How to reverse insulin resistance?
There are several methods and some are more effective than others;
1. Blood sugar lowering drugs
These include Metformin and sulphonyl urea and these can be a good band aid for lowering blood glucose. They like most drugs treat disease. They don’t cure insulin resistance and they certainly don’t treat the other issues of delayed Onset type 2 diabetes.
These along with other medications treat the complications of insulin resistance and it’s impending health issues but other long term health issues.
2. Exercise (without weight loss)
The benefits of exercise are temporary unless there is a body composition change. The results of exercise in reducing blood sugar and increased insulin sensitivity last 48 to 72 hours.
The more exercise is done the better the body will respond with reduced blood sugar and insulin sensitivity
If there is a reduction of body fat including visceral fat and an increase in muscle mass there will be a more permanent decrease in blood sugar and and insulin sensitivity.
3. Weight loss via calorie reduction and without exercise.
This method will definitely increase insulin sensitivity and decrease blood sugar when it leads to fat loss and visceral fat loss.
Unfortunately if there is a loss of muscle mass there will be a decrease in the amount of glycogen load available via absorption in muscles.
4. Weight loss with reduced calories and exercise (mainly cardio)
With this method the Calories were reduced to the same level when comparing with and without exercise. This method lead to reduction in blood sugar similar for both exercise and non exercise groups.
There was more weight lost but there was more lean tissue lost which made a difference to glucose absorption.
5. Weight loss with reduced calories and exercise but taking into account the calories burnt during exercise (cardio based)
When comparing calorie Restriction with exercise and calorie deficit taking into account exercise there was increases in insulin sensitivity and glucose reduction in both groups.
The exercise group was similar in numbers but had a greater ability to absorb glucose due to exercise. Because muscle tissue increased in the exercise group the glucose uptake increased but insulin sensitivity was similar. Fat loss was similar in both groups 7. Weight loss with resistance training and cardiovascular exercise versus calorie restriction
This lead to the greatest changes in insulin sensitivity and glucose lowering and glucose uptake.
With the increase in muscle mass and glucose uptake there was a greater decrease in blood sugar.
Conclusion
The best way to permanently decrease blood sugar and improve insulin sensitivity is to lose body fat around the belly and visceral fat around the organs.
This can be done through diet or diet and exercise. The important factors to consider is that weight loss method decreases body fat and muscle tissue is spared or there is an increase in muscle tissue.
The best method is to combine resistance training with cardiovascular exercise and to set calories at a level that is below maintenance calories based on the level of activity or exercise.
As you age it is important to preserve muscle tissue or prevent sarcopenia by exercising while maintaining a healthy body fat level.
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