Insulin resistance has been a central topic in medical research for almost a century now. Below you will learn what insulin resistance is, what it does to our body 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, please discuss all further steps with your doctor in advance!
Insulin resistance – the basis for a disturbed sugar metabolism
As 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 would not be able to reach the cells. It also has a strong anabolic (building) 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 levels in the blood rise (hyperinsulinemia). This is not noticeable in blood sugar at first. It 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 seem to have an impact on the development of insulin resistance. Our Nutrition. Lots of quickly absorbed carbohydrates lead to a rapid increase 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 white flour. If we snack now and then or eat unhealthily, the body can compensate for this well. However, if we provoke these strong increases in blood sugar every day and over years/decades, then at some point the cells will no longer react as sensitively to insulin. The pancreas has to produce even more insulin and a self-reinforcing cycle beginsThis is the beginning of insulin resistance.
Sugar comes in many different forms. Basically, they all promote insulin resistance to a similar extent.
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 a few examples. You see, insulin resistance is often the breeding ground on which other diseases thrive. The dangerous thing about it is that insulin resistance per se often causes no symptoms at all.
The good news is that early-stage insulin resistance is reversible. Accordingly, it is very worthwhile to take preventive measures here. One of the strongest advocates of prevention is the American doctor Dr. Peter Attia.
Did you know? Insulin resistance is the main cause of polycystic ovary syndrome (PCO)PCOS is the most common hormonal disorder affecting 8-13% of women of childbearing age. This disease often goes undetected because the symptoms, such as a change in voice, infertility, acne or obesity, do not suggest a disorder of sugar metabolism. PCOS is treated with metformin, a prescription drug for type 2 diabetics.
How do I detect insulin resistance?
To have a better sense of the sugar metabolism in our body, we must first understand how and what we can measureThe simplest method is to measure your blood sugar using a test strip from the pharmacy. However, this only gives us a very specific insight, which is hardly meaningful from a medical point of view. But why do we measure blood sugar and not directly insulin?
Insulin has only one very short half-life in the bloodstream. After a few minutes it has already disintegrated, 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 increased, this indicates insulin resistance. Maybe you have also heard of the HOMA index Here insulin is compared to blood sugar. High values (greater than 2.5) indicate insulin resistance.
The second possibility is the measurement of C-peptideThis is produced in the pancreas together with insulin and has a longer half-life. Endocrinologists use this value, among other things, to distinguish between diabetes mellitus type 2 (caused by insulin resistance) and diabetes mellitus type 1 (caused by insulin deficiency).
The most modern method is the possibility of continuous glucose monitoring using CGM.
CGM sensors are usually very small and adhere to the skin using an adhesive film. They need to be changed approximately every two weeks.
CGM measurement – highly individual and the future
How many carbohydrates are too many? This question cannot be answered in general terms, as every person metabolizes carbohydrates differently. A Tour de France rider can process 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, according to a study is particularly common among endurance athletes.
How can you determine your ideal carbohydrate intake? We recommend that anyone who is interested should try a Continuous Glucose Monitor (CGM) This can also be done through your family doctor in some cases.
A CGM is a small sensor chip that is usually inserted into the upper arm using a short needle.Don't worry! If it's a prick, it's a very short one and the needle doesn't stay in. Because the thin measuring thread remains in the subcutaneous fat tissue, the sensor can measure our blood sugar in real time. You can then track this via an app on your own smartphoneTo determine how many carbohydrates are too many and which carbohydrates you should avoid, all you need to do is take a quick look at your smartphone.
Tip: In the best case, blood sugar should not rise more than 30 points per mealThen you are on the best way to reduce your insulin levels in the long term.
With the help of a CGM device, insulin resistance can be detected before elevated blood sugar levels occur. These devices are still mainly intended for diabetics, in the future, however, they could be used as a screening tool for all peopleEven if the interpretation of the data is a little more complicated than with traditional laboratory tests, we could detect insulin resistance years in advance and thus take preventive action.
If you want to know more about the different ways of measuring blood sugar, please take a look at our magazine article on the subject blood sugar 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? This is the question that the scientists of this study The result even surprised the researchers themselves: Sugar-free soft drinks increased the risk of diabetes and insulin resistance the most, followed by fruit juices and sugary soft drinks! One possible explanation lies in the change in the microbiome through 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 say you identified your insulin resistance early on. Maybe you noticed 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 high-carb meal. Now the question arises, what to do? Fortunately, we now have a lot of tools in our repertoire for this purpose. The following tools are available to us in the fight against insulin resistance:
- medications
- Stress/Cortisol Management
- Good sleep
- sports/exercise
- Nutrition
1. Medications
If elevated fasting blood sugar is detected during a routine examination by your GP, “HbA1c” – the so-called long-term sugar value – requested later.HbA1c reflects the proportion of our 'sugary' red blood cells. Since these are approximately 3 months The doctor can use this to get an overview of the carbohydrate metabolism of the last 3 months. The normal values for HbA1c vary depending on gender, so the following comments are only to be understood as guidelines. From values of about 5.5% and higher, you are in a prediabetic metabolic state – not quite diabetes, but close. Up to 6.5%, medication is not usually used, because only above this value is diabetes considered to be manifest.
Lifestyle modification is considered first-line therapy – yes, you read that right – before any medication is used, patients should first improve their lifestyle. Less alcohol, less sugar and more exerciseIf that doesn't work, metformin (increases insulin sensitivity) is started. If this therapy is insufficient, SGLT2 inhibitors (increase glucose excretion) and, in the case of obesity, GLP-1 receptor agonists (make you feel full and increase insulin production) are added.
Treatment then begins with insulin, the most powerful antidiabetic drug. The advanced insulin resistance is overcome with an even higher dose of insulin.
Did you know? Rarely has a drug caused so much hype on the internet as the GLP receptor agonists. Under the trade name Ozempic or Wegovy The active ingredient semaglutide is currently being sold. Many non-diabetics take the drug because it causes significant weight loss. There were temporary supply shortages because there was a massive rush on the expensive drugs. This was further fueled by social media, among other things.
Despite adjusted medication, Many type 2 diabetics eventually experience pancreatic exhaustion, due to the constant stress called insulin production. If there was originally too much insulin in the blood, now the opposite is the case. At this stage, only insulin therapy helps. 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: Type 1 diabetics lack insulin right from the start. The reason for this is autoimmune processes that destroy the insulin-producing cells of the pancreas over the years. Accordingly must Insulin should be replaced right from the startOral antidiabetics are completely ineffective.
Medicine has a whole arsenal of different medications available to fight diabetes. But you don't have to let it get that far!
2. Stress/Cortisol Management
Who is stressed these days? Most people will raise their hands in agreement when asked this question. We live in a world flooded with stimuli, and this is reflected in our cortisol levels. If cortisol is released, the blood sugar level also increases – the body assumes that we currently need more.
cortisol is also a hormone produced by the body, which is also known as the stress hormone. In principle, this is true, but Without cortisol and stress it is not possible even in restIt wakes us up in the morning and ensures that our heart keeps beating. It also gives us the extra energy boost we need in a variety of situations.
Controlling cortisol levels does not mean switching it off completely, but rather maintaining 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 maximum 60 minutes, 3-5 times a week)
- Breathing exercises (breathe slowly in through the nose and out through the mouth for 2 minutes)
- In the morning, the first thing you should look at is not your smartphone, it is better to wait at least 1 hour
- Coffee (increases cortisol levels) no longer after 3 pm
- At least 2 hours before bedtime eat the last meal
- Put your smartphone away at least one hour before going to bed
- A balanced diet with sufficient intake of omega-3 fatty acids and magnesium regard
3. Good, adequate sleep
Who would have thought that 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 a 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 such a short period of time has such drastic consequences, what is the point of chronic lack of sleep?
magnesium is excreted en masse when there is a lack of sleep. Supplementation could therefore at least somewhat reduce the negative effects. At the same time Magnesium also significantly reduces stress and subsequently our cortisol levels.
4. Sports/Exercise
Everyone can probably imagine that exercise 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 glucose reservoir. Yes, you guessed right - we're talking about our muscles! The greater the muscle mass, the more capacity we have to store and utilize glucose.
strength training
The aim is to increase muscle mass. You don't necessarily need free weights for this. Cable pulls, rubber bands or your own body weight are completely sufficient at the beginning. The main thing is that you move your body against resistance. We recommend a regularity of 2-3x per week.
"Zone 2" cardio training
What initially sounds rather meaningless, means Cardio training at a heart rate between 130 and 140 beats per minute. In this area, the mitochondria with the highest efficiency for most people.This increases one of the most well-known fitness markers – VO2maxStudies have shown several times that even less than one hour of exercise per week can significantly reduce insulin resistance. We recommend 30-45 minutes of Zone 2 cardio per week to start with.
5. Nutrition
Simply put, insulin resistance is a disorder of carbohydrate tolerance. If insulin resistance, prediabetes or diabetes are present, carbohydrate intake should first be reduced. A general calorie reduction often carries the risk of losing muscle mass – Muscle mass is also considered to be the largest reservoir for glucose – so we don’t want to reduce it. In some circumstances, the loss of muscle mass can even make the situation worse!
That is show some studiesthat calorie restriction leads to improved insulin resistance, However, there are a few points to consider. The most important thing is that when reducing calories you always Minimum intake of 1g protein per kilogram of body weight - that's just enough to maintain muscle mass. To lose weight, 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 is also scientifically proven. It is often difficult to incorporate fasting into your everyday life. Hunger, social contacts or work make extended fasting difficult. However, there is also the possibility of imitating 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 that the Autophagy, the recycling of old cells, is stimulated. In addition, berberine help keep your blood sugar levels stable.
A ketogenic diet can also be very helpful in some cases, but is much more complex, offers some pitfalls and would go beyond the scope of this article.
What helps with insulin resistance other than fasting?
Fasting is not suitable for everyone, but it remains a very useful tool to reverse existing insulin resistance. In this study The authors were able to show, for example, 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 utilize carbohydrates.The mitochondria, also known as the powerhouses of our cells, lack glucose and fatty acids. Their function is therefore limited. In an exciting study, Prof. Sekhar and his team were able to study in type 2 diabetics, that regular intake of GlyNAC the mitochondrial function improved and thus insulin resistance decreased.
If you look at the studies on possible diets, one name comes up again and again: The Mediterranean diet. Among other things, in this study could be shown, that a Mediterranean diet can reverse insulin resistanceBut why is that?
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 secondary plant substances These molecules have a number of positive effects on our body.
The problem is that due to industrialized agriculture, the content of secondary plant substances in our food is decreasing more and more. If you eat an apple today, you can expect up to a third less secondary plant substances are contained in it. If you want to know more about secondary plant substances, then take a look our overview to do so.
There are also some natural molecules that have been shown in studies to have a positive effect on our insulin sensitivity. 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 that have a very positive effect on blood sugar levels.
Carbohydrates last – 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 consume carbohydratesTo do this, they gave type 2 diabetics a meal that was always structured the same way. It consisted of three parts
- carbohydrates (ciabatta bread and orange juice)
- egg white (chicken breast, without skin)
- vegetables (lettuce, tomatoes and cucumbers)
The individual components were always served ten minutes apart. The quantities were always the same, only the order was changed. The astonishing result: It actually makes a big difference when the carbohydrates are eaten! If carbohydrates were consumed last, the increase in blood sugar was not as steep. This allowed the scientists to show that a small change in the structure of meals can have a measurable effect.You can find more interesting studies on the subject in the book “The Glucose Trick“ by Jessie Inchauspé.
We hope you enjoyed this little insight into the world of insulin resistance and blood sugar management. Even if insulin resistance does not cause any symptoms for a long time, you now know how important the topic is for your health. With this knowledge, you now hold the reins!
