Management of Insulin Resistance
The Role of Insulin
Firstly, we must understand the role of insulin. Insulin is an essential hormone made by the pancreas that helps glucose in your blood enter cells in your muscle, fat, and liver where it is used for energy. Basically, when your blood sugar levels rise after eating, your pancreas will release insulin into the blood to lower blood sugar levels and keep it at a normal range.
What is insulin resistance?
Insulin resistance occurs when the muscles, fat, and liver don’t respond well or resist the insulin and can’t easily take up glucose from your blood. Due to this your pancreas makes more insulin to compensate. This creates a vicious cycle with insulin rising higher and blood cells becoming more resistant.
Progression of insulin resistance may cause:
- Type 2 diabetes
- Metabolic syndrome
- Non-alcoholic fatty liver disease
- PCOS
- Other chronic health conditions
How is insulin resistance acquired?
Insulin resistance is primarily related to excess body fat, though genetic causes are identified as well.
Management
The process of insulin resistance management will generally involve a team of specialist including your GP, endocrinologist, exercise physiologist and a dietitian. The GP will create a plan that outlines the goals for the team and then progress will be monitored through medical exams such as monitoring cholesterol, blood glucose levels and hypertension.
When it comes to management of insulin resistance, lifestyle modifications should be the primary focus, such as the ones listed below:
Nutritional modification
- Reduced sugars – <10g of sugar per 100g
- Controlled carbohydrates – Aim for low-GI carbohydrates as these will help keep blood sugar levels at a normal range
- High fibre – 25-35g/day
- Increase protein intake – Recommended intake is approx 0.8-1g /kg of body weight, with potential to increase dependant on the individual
- Carbohydrate- Protein- Fat balance at meals will assist with preventing insulin from spiking.
- Supplementation such as berberine and chromium that can also be used to effectively regulate and manage blood glucose levels
Exercise modification
Another important lifestyle modification includes physical activity. For good health about 30 minutes of moderate intensity exercise every day is recommended, but this can be broken up into 3 x 10-minute sessions if not possible. Exercise may include a fast-paced walk, swimming, cycling, dancing, weight training and more.
Lifestyle modifications with the help of professionals will help manage insulin resistance and its side effects. Changes in body shape will also often be seen as a result of these lifestyle changes.
What about medication?
The most commonly prescribed medication is metformin to assist with insulin sensitivity. Metformin is a biguanide and increases insulin sensitivity, enhances peripheral glucose uptake, increases fatty acid oxidation, and decreases absorption of glucose from the gastrointestinal tract. This can be prescribed by your GP or endocrinologist.