Insulin Resistance

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chenda
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Insulin Resistance

Post by chenda »

I have long suspected I have insulin resistance, however I am struggling to understand it.

From what I have read, insulin resistance is when your body’s cells don’t respond properly to the insulin that your body makes. Because your body cannot use the insulin as it should your blood sugar levels can increase - hyperglycemia.

My moods and energy frequently drop throughout the day, and eating something with a high sugar content usually fixes it within minutes. Which would suggest hypoglycemia - low blood sugar. But why would insulin resistance cause low blood sugar ? Is it because the pancreas are having to overproduce insulin to offset the body's insulin resistance, resulting in erratic peaks and troughs in blood sugar levels ?

DutchGirl
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Re: Insulin Resistance

Post by DutchGirl »

Have you visited a doctor and had some tests?

chenda
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Re: Insulin Resistance

Post by chenda »

DutchGirl wrote:
Sat Mar 18, 2023 2:21 pm
Have you visited a doctor and had some tests?
I had a blood test for diabetes a few years ago but it was negative. I was also tested for iron levels as well and they were normal.

mathiverse
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Re: Insulin Resistance

Post by mathiverse »

@chenda: You can ask your doctor for a blood test to check for insulin resistance. You get a result for fasting insulin and another for fasting glucose, then you plug it into a calculator: https://en.wikipedia.org/wiki/Homeostat ... assessment.

Alternatively, you can get an A1C blood test and see if it's high. Doctors have a cut off for considering someone pre-diabetic or not.

Another alternative is asking for an oral glucose tolerance test to see if you blood sugar stays in a normal range in the hours after ingesting glucose.

chenda
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Re: Insulin Resistance

Post by chenda »

Thanks, I'll consider that.

However, is my understanding correct that insulin resistance can cause low blood sugar for the reason I suggested ?

frommi
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Re: Insulin Resistance

Post by frommi »

No, its the opposite, at least according to chatgpt ;)
--
Insulin resistance can lead to high blood sugar levels because the body becomes less responsive to the effects of insulin, which is the hormone that regulates blood sugar levels. However, insulin resistance is not typically associated with low blood sugar levels, but rather with high blood sugar levels (hyperglycemia).

In people with insulin resistance, the pancreas may produce more insulin to compensate for the reduced sensitivity of the body's cells to insulin. This can initially lead to high blood sugar levels, which over time can contribute to the development of type 2 diabetes.

Low blood sugar levels (hypoglycemia) typically occur when there is too much insulin in the bloodstream, which can happen in people who take insulin or certain medications to treat diabetes. This can also occur in people who have certain medical conditions or who have not eaten enough food.

So while insulin resistance does not directly cause low blood sugar, it can be a risk factor for developing type 2 diabetes, which can then lead to low blood sugar if diabetes medications are not properly managed.
--
If you want to fix insuline resistance you can go to a doctor and be rolled into lifelong subscription for pills which will probably not really change your problems or you can change your diet and cut out all sugar/carbs.

7Wannabe5
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Re: Insulin Resistance

Post by 7Wannabe5 »

It might be low serotonin levels. That's why people with bi-polar or cyclothymic tendencies often experience intense sugar craving. People with cyclothymia are often misdiagnosed as ADHD. One experiment you might try is looking at something very visually stimulating when you feel craving. Something like the bright red against green background which would signal fruit to your primate brain.

Cam
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Re: Insulin Resistance

Post by Cam »

This is great timing for you to ask about this. I'm headed in for blood tests this week to try to figure out a mysterious fatigue I've been dealing with. One of the tests is the A1C and I am very interested to see if I am pre-diabetic or already have type II diabetes. I strongly suspect I'm already pre-diabetic but the test will give me a lot more to go on.

Ivor Cummins has some talks on Youtube about insulin resistance and type II diabetes. He's also written a book called Eat Rich Live Long. I've found him to be a great resource if you want to learn more.

mathiverse
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Re: Insulin Resistance

Post by mathiverse »

One benefit of going to the doctor is to see if insulin and blood sugar is the problem at all.

If you go and your A1C is 5.0%, your oral glucose tolerance test is completely normal over 6 hours (ie your blood sugar doesn't go too high or too low), and your HOMA-IR is 0.5. Then you are barking up the wrong tree completely and saved yourself the wasted time and energy going down the wrong path. Alternatively, you may confirm your problems are related to insulin resistance (even if the numbers don't point to a problem at the clinical level, eg A1C of 5.3% with HOMA-IR .8), at which point you can focus on the lifestyle changes you need to make. A prescription from a doctor doesn't force you to take the pills.

Going to the doctor and getting a test seems easier and more reliable than trying to confirm/refute a theory of insulin.

Western Red Cedar
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Re: Insulin Resistance

Post by Western Red Cedar »

Many people hyping intermittent fasting or periodic, longer fasts claim that reversing insulin resistance is on of the primary benefits. If you look into the fasting information, you are bound to learn more about insulin resistance.

It isn't clear that this is actually your problem though. Low energy and mood could result from a lot of different things. How is your sleep? Are you getting much Vitamin D? How is your hydration? Is your nutrition fairly balanced - lots of carbs?

Sugar is basically a drug, so it is natural that you are going to get a bit of a high after consuming it. How long is your energy and mood elevated after you consume sugar?

chenda
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Re: Insulin Resistance

Post by chenda »

Thanks all.

@frommi - thanks yes that makes more sense.

@Cam - I hope you get some useful results.

@western red cedar - My sleep has always been terrible, ever since I was a baby according to mum. I very rarely sleep through and often am awake half the night. I get a lot of Vitamin D , as I supplement and always get out in the sun when possible. My diet is otherwise pretty healthy according to mainstream advice. The 'sugar rush' lasts for hours, but the effect might be psychosomatic. When I did the paleo diet many years ago I did feel fantastic on it, which might have been coincidental but I wonder if the near absence of refined carbs and sugars was good for me.

I think I will get tested for this as the narrative in my mind doesn't seem to accord with the science.

jacob
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Re: Insulin Resistance

Post by jacob »

Here's my "Little Spot Went To The Bank"-understanding. (I know a few diabetics and so naturally became interested in how they broke their metabolic systems, because I'm scientific like that. This has not helped me to convince them to stop eating junk food though, so clearly there's more to it :-P )

If cells are like the Tokyo subway and sugar are the passengers, insulin hormones are the conductors pushing the passengers into the train, and the platform is the blood stream. (In order for the metaphor to work, passengers will never go on their own. They need a conductor to push. This is why insulin is crucial. Before factories could mass produce insulin, diabetes used to be a death sentence. However, it also used to be rare because overweight and obesity was rare.)

Insulin is produced by the pancreas. Some people have a genetic disease that destroys the pancreas' ability to produce it. This is type 1 diabetes and this is why type 1 is heritable. Type 2 is slightly more complicated. Type 2 happens when the subway is constantly overstuffed with passengers because there are too many passengers on the platform. First thing that happens is that the conductors get tired and less effective getting the passengers onto the train. That's insulin resistance. The company corrects that by hiring more conductors from the pancreas. At some point the pancreas say "We can't keep this up anymore! We quit!" as well. At that point conductors (insulin) has to be hired from overseas. IOW it has to be injected.

In a normally functioning body with less passengers and non-stuffed trains, the following happens. The eye may see or think about delicious food thus triggering the release of insulin. If nothing is forthcoming, the conductors empty the entire platform into one train; leaving others mostly empty. This is NOT great for the train system. This is essentially a sugar crash and the human instinctively compensates by eating fast sugars like raisins, bananas, or orange juice. Actual diabetics have another injector in case sugar level drop too low which happens if they injected too much insulin in anticipation of a feast that didn't happen. Very low blood sugar is very dangerous. It presents as a mild stroke. People start spouting nonsense and get confused. They may not realize what's happening to them.

When you go to a restaurant they'll also screw with this system by offering free carbs (chips) ... this overstimulates the insulin which in turn drops the blood sugar. The idea is that customers will get super hungry and order more.

Also, insulin is released on a regular schedule. If you eat out of schedule, the body will be surprised by the incoming sugar and overspike insulin. This in turn drops blood sugar and you'll feel like taking a nap. This is just the body's way of processing unused sugars into fat and storing it. It digests better when you're not moving so it makes you nap. People who eat donuts for breakfast and lunch suffer this kind of drowsiness on a regular basis; usually compensating with coffee.

I'm on the warrior diet or IMF or whatever the modern term is and I have sugar crashes maybe twice a year. Certainly not every day. I solve them by stuffing my face with raisins. The effect is felt after 10 mins or so.

PS: Sugar also triggers dopamine release. This is why you feel happy and why it's addictive. Indeed, extroverts being more attracted to dopamine than introverts tend to have a higher BMI. Partially explained here: viewtopic.php?p=271040#p271040

chenda
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Re: Insulin Resistance

Post by chenda »

Thanks @Jacob thats interesting. So an insulin spike could be triggered psychosomatically ? If I start to salivate over a load of doughnuts and cream but don't actually eat anything, I'm still risking a drop in blood sugar due to the excess insulin ?

Yeah type 1 diabetes was once a death sentence. Children born with the condition rarely made it to adulthood until insulin was discovered in the 1920s.

frommi
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Re: Insulin Resistance

Post by frommi »

What i have taken from youtube videos about this subject is that your body can run on two types of fuel, either glucose or ketones. Glucose needs insulin to work and get into the cells/brain while ketones are produced and worked with when you start to crave sugar and the body uses stored fat to function. So if you want to get rid of these sugar craving phases you should have your body in a state where it can process ketones. It typically takes 2-3 days of low carb intake to get into this state. You can also get into that state by fasting. When your body is keto adapted, you dont need glucose at all.

Chat GPT is again much better than i am to produce a good answer:
Ketones are a type of organic molecule that are produced by the liver when the body breaks down fat for energy in the absence of sufficient glucose. They can be used as an alternative energy source when glucose levels are low, such as during periods of fasting, prolonged exercise, or when following a low-carbohydrate diet.

The three main types of ketones produced in the body are acetone, acetoacetate, and beta-hydroxybutyrate. Acetone is the simplest and most volatile of the three, while acetoacetate and beta-hydroxybutyrate are more stable and are usually measured in blood tests.

High levels of ketones in the blood, known as ketosis, can occur when the body is burning fat for energy instead of glucose.

VinceJ
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Re: Insulin Resistance

Post by VinceJ »

frommi wrote:
Mon Mar 20, 2023 2:52 am
What i have taken from youtube videos about this subject is that your body can run on two types of fuel, either glucose or ketones. Glucose needs insulin to work and get into the cells/brain while ketones are produced and worked with when you start to crave sugar and the body uses stored fat to function. So if you want to get rid of these sugar craving phases you should have your body in a state where it can process ketones. It typically takes 2-3 days of low carb intake to get into this state. You can also get into that state by fasting. When your body is keto adapted, you dont need glucose at all.

Chat GPT is again much better than i am to produce a good answer:
Ketones are a type of organic molecule that are produced by the liver when the body breaks down fat for energy in the absence of sufficient glucose. They can be used as an alternative energy source when glucose levels are low, such as during periods of fasting, prolonged exercise, or when following a low-carbohydrate diet.

The three main types of ketones produced in the body are acetone, acetoacetate, and beta-hydroxybutyrate. Acetone is the simplest and most volatile of the three, while acetoacetate and beta-hydroxybutyrate are more stable and are usually measured in blood tests.

High levels of ketones in the blood, known as ketosis, can occur when the body is burning fat for energy instead of glucose.
Small note: while you're on low carb keto-style energy cycle - be ready to have a "flatline" energy feeling : while on usual glycose energy cycle you usually have more energy before some sort of activity and gradually you become more and more "drained" over doing something. Meanwhile in state of ketosis you're going feeling a bit less energy from the start, but usually not going to experience a fast drop(which was something new for me, especially since I've been trailing for years and got pretty used to conserving my energy from the start. Biggest downside was that I couldn't opt for my usual "energy" snacks like PB while doing it, kinda messed me up a bit. Also since keto-friendly stuff aren't as easy to optimise - my backpack was kinda low on space too even though I'm running 44l one from nearby outdoor sports store).

Man this chatgpt thing is spreading so fast, I would never expect this to be written by a bot...
Last edited by VinceJ on Mon Apr 17, 2023 6:30 am, edited 1 time in total.

IlliniDave
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Re: Insulin Resistance

Post by IlliniDave »

IR has been my obsession lately. One of the key ways to discern probable insulin resistance is a triglyceride/HDL ratio > ~1.5 (ethnicity dependent), which is something you can get from most basic bloodwork though you might have to calculate it yourself. The best is getting a fasting insulin measurement from your medical provider, but it's not a standard test. Fasting blood glucose is standard, but unfortunately it's the last thing to reveal underlying problems.

The problem is that IR is a stage of a continuum of malady which begins much sooner. The TG/HDL ratio above is the threshold where your risk for a number of "chronic" diseases ratchets up.

Whenever you eat carbohydrates (more so when it comes to sugar and refined starches) your body releases insulin which among other things tells many of your cells open up and absorb glucose taken in from your food. The pathology begins with a combination of frequent meals/snacks and foods high in sugar or refined starches. This leads to almost continuous presence of insulin in the blood. When your cells have absorbed glucose until they are "full" they begin to ignore the signal to open up for more glucose. That causes blood glucose to stay high and in reaction the pancreas produces more insulin which is dumped in the blood to force the glucose somewhere (in time largely into visceral fat cells). Over years and decades of frequent high carbohydrate meals ever higher levels of insulin are produced which is increasingly ignored by cells. The ignoring of insulin by cells that should respond to it is "insulin resistance". Eventually the pancreas cannot keep up with the demand for insulin in response to blood glucose and fasting blood glucose begins to rise (pre-diabetes) and ultimately your pancreas can wear out so that the amount of insulin it can produce drops raising blood glucose even higher marking the onset of full "clinical" type-II diabetes. Another path that exacerbates IR is developing a "fatty liver" which iirc is largely caused by it being overwhelmed by fructose (from fruits, table sugar, and some artificial sweeteners) against the backdrop of ever-present insulin. The liver stores the broken down fructose into fat within the liver degrading its function and the liver itself becomes insulin resistant.

Generally, the two main non-drug ways to deal with and often somewhat reverse IR are low carbohydrate eating regimens and restricted eating windows/intermittent fasting. Often practiced together. Since IR is the result of years/decades of improper nutrition it tends to take similar time spans to restore insulin sensitivity (may never be able to restore it fully), meaning essentially permanent nutritional lifestyle changes are necessary. Nutrition changes are the cornerstone but things like increased activity level/exercise, supplements, and stress management can all help the process.

If you imagine pre-agricultural humans it is easy to picture people undergoing extended periods (by modern standards) between opportunities to eat, long stretches of very little food availability (e.g., late fall through early summer), and only short periods during the year when food high in carbohydrates, especially sugar, were available (late summer, early autumn). Not only are we evolved around such resource availability rhythms, but our body is designed to leverage extended low insulin periods for a lot of cellular repair and regeneration activities, which are largely blocked by following SAD/contemporary nutritional guidelines. So the benefits of eating to undo IR are wide ranging.

This video hits most of the high points and ties in the whole "metabolic syndrome" family of maladies of which IR is part. The guy can be a little tedious to listen to, but I've found him to be pretty reliable. And if IR is something you are concerned about it's probably worth the half hour.

https://www.youtube.com/watch?v=-BI-rlA6TBQ

The video talks a little bit about blood sugar/insulin swings from frequent (4-6 times/day) highish GI carbohydrate intakes. I don't think that's a sign of IR per se, but it is sort of a co-symptom of nutritional patterns that in time will result in IR.

Although I don't think I've said much about all the underlying biology, I've spent most of 2023 in my journal talking about my efforts to battle IR and the cluster of things that come with it.

mathiverse
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Re: Insulin Resistance

Post by mathiverse »

IlliniDave wrote:
Mon Mar 20, 2023 6:07 am
One of the key ways to discern probable insulin resistance is a triglyceride/HDL ratio > ~1.5 (ethnicity dependent)
Hey iDave, do you know where one can find info about the threshold for different ethnicities?

IlliniDave
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Re: Insulin Resistance

Post by IlliniDave »

mathiverse wrote:
Mon Mar 20, 2023 10:30 am
Hey iDave, do you know where one can find info about the threshold for different ethnicities?
The video I linked a couple posts up mentions it in passing, but I don't know of a comprehensive source offhand. Some authorities say that for people of European descent seem to have the most leeway: a TG/HDL ratio up to 2.5 indicates relatively low cardiovascular risk (although at the upper end it's not ideal). For people of African descent a lower ratio (1.5?) is where cardiovascular risk goes up rapidly. People of South Asian ancestry have some different concerns when it comes to metabolic issues (many of them can tolerate substantial metabolic disorder without gaining excess fat, meaning things often go undiagnosed, longer but I don't know how it maps into that ratio. I'm shooting to get my ratio near or even under 1.0. The closest I've found to a consensus is that a ratio under 1.0 is an indicator of good/strong metabolic health and by extension good insulin sensitivity for all.

chenda
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Re: Insulin Resistance

Post by chenda »

IlliniDave wrote:
Mon Mar 20, 2023 6:07 am
This video hits most of the high points and ties in the whole "metabolic syndrome" family of maladies of which IR is part. The guy can be a little tedious to listen to, but I've found him to be pretty reliable. And if IR is something you are concerned about it's probably worth the half hour.

https://www.youtube.com/watch?v=-BI-rlA6TBQ
That was worth listening to, it does makes sense. Fasting intuitively feels like something healthy as its something we would have done naturally, and gives cells and organs a regular rest from insulin. As an aside, it is often speculated that acne is indirectly caused by insulin resistance. Insulin is a master hormone which effects other hormones. IIrc teenagers naturally have higher rates of insulin resistant due to puberty, and there is also evidence that acne is much less common in cultures following diets closer to paleo/Low GI. https://www.acne.org/glycemic-load-diet-and-acne

Just following a low Glycemic Load diet might be the easiest way to address this. I have a tendency to want to gorge on pasta and bread at lunchtime but I know I'll feel a lot better in the afternoon after a salad.

@frommi - There is some interesting research which suggests that the Keto diet can help with autism.

IlliniDave
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Re: Insulin Resistance

Post by IlliniDave »

chenda wrote:
Mon Mar 20, 2023 1:17 pm
That was worth listening to, it does makes sense. Fasting intuitively feels like something healthy as its something we would have done naturally, and gives cells and organs a regular rest from insulin. As an aside, it is often speculated that acne is indirectly caused by insulin resistance. Insulin is a master hormone which effects other hormones. IIrc teenagers naturally have higher rates of insulin resistant due to puberty, and there is also evidence that acne is much less common in cultures following diets closer to paleo/Low GI. https://www.acne.org/glycemic-load-diet-and-acne

Just following a low Glycemic Load diet might be the easiest way to address this. I have a tendency to want to gorge on pasta and bread at lunchtime but I know I'll feel a lot better in the afternoon after a salad.

@frommi - There is some interesting research which suggests that the Keto diet can help with autism.
I'm not sure about teenagers, but acne/rosacea in adults, especially women, is supposed to be a pretty reliable indicator of insulin resistance.

It's more than a rest from insulin, it's a rest from processing incoming energy from the gut. The process of burning glucose is messy (byproducts) and stressful to mitochondria. Down time for repair and cleanup (which, as an aside, ketones signal the cell mitochondria to commence). Processing incoming fat, fructose, and excess glucose puts a strain on primarily the liver. It's arguable that regular intermittent fasting is beneficial even to people who have not eaten themselves into insulin resistance. IIRC it takes something like 6-8 hours for everything from a meal to process, so non-eating windows need to probably at least double that for any meaningful repair/autophagy/etc to occur. So I think it would depend on the person's initial state of health how effective sticking to 3 or more feedings a day on a low GI regimen would be. My guess would be leave at least 3 hours between the last caloric swallow and bed time, and aim for 8-9 hours sleep. If you can delay breakfast a little all the better. I will say from experience that after a week or so to adjust to a low carb regimen it gets increasingly easy for me to pinch my feeding window down to 2 hours or so.

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