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 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, then discuss all further steps with your doctor in advance!
Insulin resistance – the basis for impaired sugar metabolism
Reminder: Insulin is a hormone 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 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 initially noticeable when it comes to 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 impact on the development of insulin resistance. Our diet also plays an important role. Many quickly absorbed carbohydrates lead to a rapid increase in our blood sugar levels. The pancreas responds to this sudden increase with a large amount of insulin so that the excess sugar from the bloodstream can be absorbed 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 less healthily, the body can compensate well. However, if we provoke these strong increases in blood sugar every day and over a period of 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 begins. This 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 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 action here. One of the strongest advocates for prevention is the American doctor Dr. Peter Attia.
Did you know? Insulin resistance is the Main cause of polycystic ovary syndrome (PCO). At 8-13%, polycystic ovary syndrome is the most common hormonal disorder in women of childbearing age. This disease often goes undiagnosed because the symptoms, such as a changed voice, infertility, acne or obesity, do not suggest a disorder in sugar metabolism. PCOS 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 sugar metabolism in our body, we first need to understand how and what we can measure. The easiest 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 sugar at all and not insulin directly?
Insulin only has a very short half-life in the bloodstream. After just a few minutes it has already broken down, making accurate measurement difficult. There are two ways how you can still use insulin directly or can be measured indirectly. The first is the morning measurement of the “fasting insulin level”. If these values are increased, this indicates insulin resistance. Maybe you've already heard of the HOMA index ? Here insulin is compared to 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 (triggered by insulin deficiency).
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. A change must take place 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 because every person metabolizes carbohydrates differently. A Tour de France rider can consume 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, according to a study a diet rich in carbohydrates is particularly common among endurance athletes.
How can you now determine where your ideal carbohydrate amount is? We recommend that anyone who is interested wear a Continuous Glucose Monitor (CGM) for 2-4 weeks. In some cases, this is also possible through your family doctor.
A CGM is a small sensor chip that you usually stick into your upper arm with a short needle. No fear! This gives a very short prick, if any, 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 using the app on your own smartphone. To determine how many carbohydrates are too much and which carbohydrates you should avoid, all you need to do is take a quick look at your smartphone.
Tip: In the best case scenario, blood sugar should not rise more than 30 points per meal. Then you are well on your way to reducing your own 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 primarily intended for diabetics, but in the future they could be used as a screening tool for all people. Even if the interpretation of the data is a little more complicated than with classic laboratory tests, we could detect insulin resistance years in advance and thus take appropriate preventive action.
If you want to know more about the different ways to measure blood sugar, then take a look at our magazine article on the topic Blood sugar values on. 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, or? This is the question Among other things, the scientists in this study investigated. 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! A possible explanation lies in the change in the microbiome caused 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. Maybe you've noticed elevated fasting blood sugar, or you've used a CGM device and seen that it takes a long time for your blood sugar to return to normal after a high-carbohydrate meal. Now the question naturally arises, what to do? Fortunately, we now have a lot in our repertoire for this purpose. The following tools are available to us in the fight against insulin resistance:
- Medicines
- Stress/Cortisol Management
- Good sleep
- Sport/exercise
- Nutrition
1. Medication
If elevated fasting blood sugar is detected during a routine examination by the family doctor, “HbA1c” – the so-called long-term sugar value – is usually requested. HbA1c reflects the proportion of our 'sugared' red blood cells. Since they live for approximately 3 months , the doctor can use this to get an overview of their carbohydrate metabolism over the last 3 months. The normal values for HbA1c vary depending on gender, so the following comments are to be understood as guidelines only. From values of around 5.5% and higher you are in a pre-diabetic metabolic state - not quite diabetes yet, but close to it. Up to 6.5%, you usually don't take any medication, because it's only at this level that you speak of manifest diabetes.
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 exercise. If that doesn't work, metformin (increases insulin sensitivity) is started. If insufficient success is achieved with this therapy, SGLT2 inhibitors (increase glucose excretion) are recommended and, if you are overweight, if necessary. GLP-1 receptor agonists (make you feel full and increase insulin production) are also added.
Then therapy is 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 caused as much hype online as the GLP receptor agonists. The active ingredient semaglutide is currently sold under the trade name Ozempic or Wegovy . Many non-diabetics take the medication because it causes significant weight loss. At times there were delivery bottlenecks because there was a massive rush for the expensive medicines. This was further fueled by social media, among other things.
Despite appropriate medication, the pancreas of many type 2 diabetics can eventually become exhausted due to the constant stress called insulin production. While there was originally too much insulin in the blood, the opposite is now 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 in the pancreas over the years. Accordingly Insulin must be replaced right from the start. Oral antidiabetic drugs are completely ineffective.
Medicine provides a whole arsenal of different medications to combat 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 hand in agreement when asked this question. We live in a world overloaded with stimuli, and this is also 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 and is also known as the stress hormone. In principle, that's true, but It's not possible to be completely free of cortisol and stress, even when you're at rest. It wakes us up in the morning and keeps our heart beating. It also gives us the extra boost of energy we need in a variety of situations.
Checking the cortisol level 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 units of a maximum of 60 minutes, 3-5 times a week)
- Breathing exercises (breathe in slowly through your nose and out through your mouth for 2 minutes)
- You shouldn't look at your smartphone first in the morning; it's better to wait at least 1 hour
- Coffee (increases cortisol levels) no longer after 3 p.m.
- Eat your last meal at least 2 hours before go to bed
- Put your smartphone away at least an hour before going to bed
- A balanced diet with sufficient intake of Omega-3 fatty acids and Magnesium pay attention
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 per night for 2 weeks has a negative impact on our insulin levels and Glucose utilization affects. Accordingly, glucose tolerance was significantly reduced and cortisol levels were significantly increased. If such a short period of time has such drastic consequences, then what's the point of a chronic lack of sleep?
Magnesium is excreted en masse when there is a lack of sleep. Supplementation could 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 exercise is good for our blood sugar. But why is that actually the case? Primarily it has to do with our body's own reservoir for glucose. Yes, you guessed it right – that means our muscles! The larger the muscle mass, the more capacity we have to store and utilize glucose.
Strength training
It is important to increase muscle mass. It doesn't necessarily have to be free weights. Cable pulls, rubber bands or your own body weight are completely sufficient in the beginning. The main thing is to move your body against resistance. We recommend a regularity of 2-3x per week.
“Zone 2” cardio training
Which sounds pretty meaningless at first, it means Cardio training with a heart rate between 130 and 140 beats per minute. In this area, the mitochondria work with the highest efficiency in most people. This increases one of the most well-known fitness markers – VO2max. Studies have shown several times that insulin resistance can be significantly reduced even with less than an hour per week. We recommend 30-45 minutes of Zone 2 cardio per week to start with.
5. Nutrition
Insulin resistance is, simply put, a disorder of carbohydrate tolerance. If you have insulin resistance, prediabetes or diabetes, your carbohydrate intake should first be reduced. A general calorie reduction often carries the risk of losing muscle mass - Muscle mass is also considered the largest reservoir for glucose - so we don't want to reduce that. In some circumstances, the loss of muscle mass can even make the situation worse!
Although some studies show that calorie restriction leads to improved insulin resistance, there are some points to note. The most important thing is that when reducing calories, you always pay attention to a minimum intake of 1g of protein per kilogram of body weight - that's just enough to maintain muscle. To lose weight, we recommend around 1.5-2g of protein per kilogram of body weight. In addition to improving insulin resistance, fasting can bring you other health benefits. The 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. Feeling hungry, social contacts or work make extended fasting difficult. However, there is also the possibility of molecularly imitating fasting.
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 autophagy, recycling , is boosted by old cells. In addition, Berberine helps you keep your blood sugar levels stable.
A ketogenic diet can also be very helpful in some cases, but it is significantly more complex, offers some pitfalls and is 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 for reversing 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 power plants of our cells, lack glucose and fatty acids. This limits their function. Prof In an exciting study on type 2 diabetics, Sekhar and his team were able to show that regular intake of GlyNAC which improved mitochondrial function and thus insulin resistance decreased.
If you look at the studies on possible diets, one name always comes up: The Mediterranean diet. Among other things, in this study it was shown that a Mediterranean diet can reverse insulin resistance. But why is that?
Mediterranean diet – the Adriatic key to longevity
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 that it contains up to a third less secondary plant substances . If you want to know more about secondary plant substances, then take a look at our overview .
There are also one or two 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 secondary plant substances, 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 investigated whether it makes a difference when we consume carbohydrates. To do this, they gave type 2 diabetics a meal that was always structured in the same way. This consisted of three parts
- Carbohydrates (Ciabatta bread and orange juice)
- Protein (chicken breast, without skin)
- Vegetables (lettuce, tomatoes and cucumbers)
The individual components were always served ten minutes apart. The quantities were always the same, they just swapped the order. The amazing 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 able to show that even a small change in the structure of meals has a measurable effect. You can also find further interesting studies on the 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 sugar management. Even if insulin resistance doesn't cause any symptoms for a long time, you now know how important the issue is for your health. With this knowledge, you now hold the reins in your hand!
You might also be interested in:
