Insulin resistance has been a key topic in medical research for almost a century now. In the following, you will learn what insulin resistance is, what it does to our bodies and how you can stop and perhaps even reverse this disease-promoting process.
Disclaimer: If you have already been diagnosed with diabetes and are already taking medication, discuss all further steps with your doctor in advance!
Insulin resistance - the basis for a disturbed sugar metabolism
A reminder: Insulin is a hormone that is produced in the pancreas and plays a central role in carbohydrate and fat metabolism. It ensures that our cells primarily absorb more glucose and fatty acids. Without insulin, the glucose circulating in the blood could not enter the cells. It also has a strong anabolic (anabolic) effect.
What is insulin resistance
When cells or organs become more insulin resistant, the pancreas has to produce more and more insulin to keep our sugar metabolism in balance - our insulin level in the blood rises (hyperinsulinemia). This is not initially noticeable in the blood sugar. This only happens when the system quietly decompensates. But how can this happen?
The exact background has not yet been fully researched. Genetic factors, lifestyle and stress levels all appear to have an effect on the development of insulin resistance. Our nutritionalso plays an important role. Lots of rapidly absorbable carbohydrates lead to a rapid rise in our blood sugar levels. The pancreas reacts to this sudden increase with a large amount of insulin so that the excess sugar can be absorbed from the bloodstream into our cells.
This happens, for example, when we consume foods with a high glycemic index, such as rice, sugar or light flour. If we snack from time to time or occasionally eat an unhealthy diet, the body can compensate well. However, if we provoke these sharp rises in blood sugar every day for years/decades, then at some point the cells no longer react as sensitively to insulin. The pancreas has to produce even more insulin and a self-reinforcing cycle begins. This is the beginning of insulin resistance.
Sugar comes in many different forms. Basically, they all promote insulin resistance to a similar degree.
Why is maintaining insulin sensitivity important for your health
Insulin resistance plays a central role in the development of type II diabetes mellitus, non-alcoholic fatty liver disease (NAFLD), atherosclerosis and Alzheimer's disease - to name just a few examples. As you can see, insulin resistance is often the breeding ground on which other diseases thrive. The dangerous thing is that insulin resistance per se often causes no symptoms at all.
The good news is that insulin resistance can be reversed at an early stage. Accordingly, it is very worthwhile to take preventive action here. One of the strongest advocates of prevention is the American physician Dr. Peter Attia.
Did you know Insulin resistance is the main cause of polycystic ovary syndrome (PCO). At 8-13%, PCO syndrome is the most common hormonal disorder in women of childbearing age. This condition often remains undiagnosed as the symptoms, such as a change in voice, infertility, acne or obesity, do not suggest a disorder in sugar metabolism. PCO syndrome is treated with metformin, a prescription medication for type 2 diabetics.
How do I detect insulin resistance?
In order to have a better sense of the sugar metabolism in our body, we first need to understand how and what we can measure . The simplest method is to measure your blood sugar using a test strip from the pharmacy. However, this only gives us a very selective insight, which is hardly meaningful from a medical perspective. But why do we measure blood glucose at all and not insulin directly ?
Insulin only has a very short half-life in the bloodstream. After a few minutes, it has already decayed, which makes accurate measurement difficult. There are two ways to measure insulin directly or indirectly. The first is the morning measurement of the "fasting insulin level ". If these values are elevated, this indicates insulin resistance. Perhaps you have also heard of the HOMA index ? Here the insulin is set in relation to the blood sugar. High values (greater than 2.5) indicate insulin resistance .
The second option is to measure the C-peptide . This is produced in the pancreas together with insulin and has a longer half-life. Endocrinologists use this value, among other things, to differentiate between type 2 diabetes mellitus (caused by insulin resistance) and type 1 diabetes mellitus (caused by a lack of insulin) .
The most modern method is probably the possibility of continuous glucose measurement using CGM .
CGM sensors are usually very small and self-adhesive to the skin using an adhesive film. They need to be changed approximately every two weeks.
CGM measurement - highly individualized and the future
How many carbohydrates are too many? This question cannot be answered in general terms, as everyone metabolizes carbohydrates differently. A Tour de France rider can metabolize an enormous amount of carbohydrates. The requirement is over 1000 grams - per day! However, the cells of a professional cyclist also react very sensitively to insulin, which is why a carbohydrate-rich diet is particularly common among endurance athletes, according to a study .
So how can you determine your ideal carbohydrate intake? We recommend that anyone who is interested should wear a Continuous Glucose Monitor (CGM) for 2-4 weeks. This is also possible on a case-by-case basis via your GP.
A CGM is a small sensor chip that you normally insert into your upper arm with a short needle. Don't be afraid! It gives a very short prick, if at all, and the needle does not stay in. By leaving the thin measuring thread in the subcutaneous fatty tissue, the sensor can measure our blood sugar in real time. You can then track this using an app on your own smartphone . A quick glance at your smartphone is enough to determine how many carbohydrates are too many and which carbohydrates you should avoid.
Tip: Blood sugar should ideally not rise by more than 30 points per meal . Then you are well on the way to reducing your own insulin levels in the long term.
With the help of a CGM device, insulin resistance can be detected before blood glucose levels rise. These devices are still mainly intended for diabetics, but in future they could be used as a screening tool for all people . Even if the interpretation of the data is somewhat more complicated than with the classic laboratory tests, this would allow us to detect insulin resistance years in advance and take appropriate preventive action.
If you want to know more about the different ways of measuring blood glucose, then take a look at our magazine article on the topic Blood glucose levels . Here we explain in more detail which measurement methods are available.
Did you know If sugar or carbohydrates are the problem, then replacing soft drinks with their sugar-free alternatives should help, right? The scientists in this study , among others, investigated this question. The result surprised even the researchers themselves: Sugar-free soft drinks increased the risk of diabetes and insulin resistance the most, followed by fruit juices and sweetened soft drinks ! One possible explanation lies in the alteration of the microbiome by the sweeteners.
While soft drinks are already a real nightmare for our blood sugar levels, researchers have found that various sugar-free alternatives significantly increase the risk of insulin resistance.
How can I reverse insulin resistance?
Let's assume you recognized your insulin resistance early on. Perhaps you noticed an elevated fasting blood sugar, or you used a CGM device and saw that it takes a long time for your blood sugar to return to normal after a carbohydrate-rich meal. Now, of course, the question is what to do about it. Luckily, we now have a lot in our repertoire for this purpose. The following tools are available to us in the fight against insulin resistance:
- Medikamente
- Stress/Cortisol Management
- Guter Schlaf
- Sport/Bewegung
- Ernährung
1. medication
If an elevated fasting blood glucose level is detected during a routine check-up at the GP's, "HbA1c" - the so-called long-term glucose value - is usually requested. HbA1c reflects the proportion of our 'sugared' red blood cells. As these live for approximately 3 months , the doctor can use this to get an overview of the carbohydrate metabolism over the last 3 months. The standard values for HbA1c vary depending on gender, which is why the following comments should only be seen as guidelines. From values of around 5.5% and higher, you are in a prediabetic metabolic state - not quite diabetes yet, but close to it. Up to 6.5%, medication is not usually used, because only from this value is it considered manifest diabetes.
The first-line therapy is lifestyle modification - yes, you read that right - before any medication is used, patients should first improve their lifestyle. Less alcohol, less sugar and more exercise . If this does not work, metformin (increases insulin sensitivity) is started. If insufficient success is achieved with this therapy, SGLT2 inhibitors (increase glucose excretion) and, if overweight, possibly gLP-1 receptor agonists (make you feel full and increase insulin production) are also added.
Therapy is then carried out with insulin, the strongest antidiabetic drug. The highly advanced insulin resistance is broken with an even higher dose of insulin.
Did you know Rarely has a drug generated as much hype on the net as the GLP receptor agonists . The active ingredient semaglutide is currently sold under the trade name Ozempic or Wegovy . Many non-diabetics take the drug because it leads to significant weight loss. At times there were supply bottlenecks, as there was a mass rush for the expensive medication. This was further fueled by social media, among other things.
Despite adjusted medication, the pancreas of many type 2 diabetics can eventually become exhausted due to the constant strain called insulin production. If there was originally too much insulin in the blood, the opposite is now the case. At this stage, only insulin therapy can help. This is the only case in which a lifestyle change or therapy with insulin sensitizers (such as metformin) alone no longer brings any significant benefit.
Important side note: In type 1 diabetics, insulin is missing from the very beginning. The reason for this is autoimmune processes that destroy the insulin-producing cells of the pancreas over the years. Correspondingly insulin must be replaced from the very beginning. Oral antidiabetics are completely ineffective.
Medicine provides a whole arsenal of different drugs in the fight against diabetes. But you don't have to let it get that far!
2. stress/cortisol management
Who has stress today? Most people will raise their hands in agreement to this question. We live in a world flooded with stimuli, which is also reflected in our cortisol levels. When cortisol is released, the blood sugar level also increases as a result - the body assumes that we currently need more.
Cortisol is also a hormone produced naturally in the body and is also known as the stress hormone. In principle, this is true, but it is not possible without cortisol and stress, even at rest . It wakes us up in the morning and keeps our heart beating. It also gives us the necessary extra boost of energy in a wide variety of situations.
Controlling cortisol levels therefore does not mean switching it off completely, but keeping to the natural rhythm. High in the morning, low in the evening.
Tips for managing cortisol levels:
- Regular strength and endurance training several times a week (short sessions of no more than 60 minutes, 3-5 times a week)
- Breathing exercises (inhale slowly through the nose for 2 minutes and exhale through the mouth)
- Don't look at your smartphone first thing in the morning, it's better to wait at least 1 hour
- Coffee (increases cortisol levels) no longer after 3 pm
- Eat your last meal at least 2 hours before going to sleep
- put your smartphone away at least one hour before going to bed
- Eat a balanced diet with a sufficient intake of omega-3 fatty acids and magnesium
3. Good adequate sleep
Who would have thought that a lack of sleep not only makes us tired, but also drastically increases the risk of metabolic diseases? Studies have shown that reducing sleep to 4 hours per night for 2 weeks has a negative effect on our insulin levels and glucose utilization. Accordingly, glucose tolerance was significantly reduced and cortisol levels were significantly increased. If even such a short time has such drastic consequences, what are the benefits of chronic sleep deprivation?
Magnesium is excreted en masse under sleep deprivation. Supplementation could therefore at least curb the negative effects a little. At the same time magnesium also significantly reduces stress and subsequently our cortisol levels .
4. Sport/Exercise
Everyone can probably guess that sport is good for our blood sugar. But why is that actually the case? First and foremost, it has to do with our body's own reservoir of glucose. That's right - we're talking about our muscles! The greater the muscle mass, the more capacity we have to store and utilize glucose .
Krafttraining
The aim is to increase muscle mass. This does not necessarily have to involve free weights. Cable pulleys, elastic bands or your own body weight are perfectly adequate to start with. The main thing is to move your body against resistance. We recommend a regularity of 2-3x per week .
"Zone 2" cardio training
What sounds rather meaningless at first means cardio training at a heart rate between 130 and 140 beats per minute . In this range, the mitochondriawork with the highest efficiency in most people. This increases one of the best-known fitness markers - VO2max . Studies have repeatedly shown that even less than one hour per week can significantly reduce insulin resistance. We recommend 30-45 minutes of Zone 2 cardio per week.
for starters
5. nutrition
Insulin resistance is, simply put, a disorder of carbohydrate tolerance. If insulin resistance, prediabetes or diabetes is present, carbohydrate intake should be reduced first. A general reduction in calories often entails the risk of losing muscle mass - muscle mass is also the largest reservoir of glucose - so we don't want to reduce it. Under certain circumstances, the loss of muscle mass can even make the situation worse!
While some studies show that calorie restriction leads to improved insulin resistance, there are a few points to bear in mind. The most important thing to remember is that you should alwaysconsume a minimum of 1g of protein per kilogram of body weight when reducing calories - this is just enough to maintain muscle mass. For weight loss, we recommend around 1.5-2g of protein per kilogram of body weight. In addition to improved insulin resistance, fasting can bring you other health benefits. Longevity genes are activated during fasting via various molecular mechanisms .
Did you know Fasting is considered healthy and, thanks to recent studies, this has also been scientifically proven. It is often difficult to incorporate fasting into your everyday life. The feeling of hunger, social contacts or work make extended fasting difficult. However, it is also possible to imitate fasting molecularly .
With the MoleQlar Fasting Bundle you can biochemically activate the health-promoting signaling pathways. Glucosamine activates SIRT1, one of the most important longevity genes. Spermidine supports this process and ensures thatautophagy, the recycling of old cells, is boosted. In addition, Berberin helps to keep your blood sugar levels stable.
A ketogenic diet can also be very helpful in some cases , but is much more complex, has some pitfalls and is beyond the scope of this article.
What helps with insulin resistance apart from fasting?
Fasting is not suitable for everyone, but it remains a very useful tool that can be used to reverse existing insulin resistance. In this study , for example, the authors were able to show that fasting for several days in overweight type 2 diabetics greatly reduces liver fat and decreases insulin resistance.
Did you know Insulin resistance makes it harder for us to metabolize carbohydrates. The mitochondria, also known as the power plants of our cells, lack glucose and fatty acids as a result. This restricts their function. Prof. Sekhar and his team were able to show in an exciting study on type 2 diabetics, that the regular intake of GlyNAC improved mitochondrial function and thus reduced insulin resistance.
If you look at the studies on possible diets, one name comes up again and again: The Mediterranean diet . In this study, among others, it was shown that a Mediterranean diet can reverse insulin resistance. But what is the reason for this
Mediterranean diet - the Adriatic longevity key
Let's take a look at what a Mediterranean diet actually consists of. In addition to proteins from legumes and fish, there are a number of plant species on the menu. These have a high content of phytochemicals . These molecules have a number of positive effects on our body.
The problem is that due to industrialized agriculture, the content of phytochemicals in our food is decreasing more and more. If you eat an apple today, you can expect it to contain up to a third less secondary plant substances in it . If you want to know more about phytochemicals, take a look at our overview of them.
There are also some natural molecules that have had a positive effect on our insulin sensitivity in studies.They also significantly reduce the blood sugar spike after a meal . These include in particular berberine and carnosine.
The Mediterranean diet contains many healthy fats and phytochemicals, which have a very positive effect on blood sugar levels.
Carbohydrates at the end - does it make a difference in which order we eat?
In a very interesting study researchers have investigated whether it makes a difference when we eat carbohydrates . To do this, they gave type 2 diabetics a meal that always had the same structure. This consisted of three parts
- Carbohydrates (ciabatta bread and orange juice)
- Protein (chicken breast, skinless)
- Vegetables (lettuce, tomatoes and cucumber)
The individual components were always served ten minutes apart. The quantities were always the same, they just swapped the order. The astonishing result: It actually makes a striking difference when the carbohydrates are eaten ! If the carbohydrates were consumed last, the rise in blood sugar was not as steep. The scientists were thus able to show that even a small change in the structure of meals has a measurable effect. You can also find more interesting studies on this topic in the book " The Glucose Trick " by Jessie Inchauspé.
We hope you enjoyed this little insight into the world of insulin resistance and blood glucose management. Even if insulin resistance doesn't cause any symptoms for a long time, you now know how important this topic is for your health.With this knowledge, you now hold the reins!
