Insulin resistance
To understand Insulin Resistance we must start with insulin. Insulin is a hormone made in the pancreas whose job is to bring fuel, which is sugar, into the cells that need it. Insulin levels are normal low overnight when we’re not eating and increase very quickly after food, especially sweets. If we are totally without insulin (called Type 1 Diabetes Mellitus) we will die as our cells starve. However, today, at least in the developed world, sugary and highly processed foods are in abundance, obesity and inactivity are common and the result is increased insulin resistance.Insulin Resistance means that we can make insulin but that insulin can’t do its job of getting sugar into cells. Therefore our body must make more insulin. Insulin is a growth stimulator, especially of fat around the organs in our bellies and fat within the liver. Also, although it is complex, higher insulin levels make us hungrier! This vicious cycle leads to Type 2 Diabetes in which we have enough insulin, but not enough insulin action. Insulin resistance is also related to higher risks for heart disease, stroke and some cancers.Insulin resistance used to begin in older aged men and women but now it is occurring in younger and younger people, even in children. Insulin resistance tends to run in families that had elders or anyone diagnosed with Type 2 Diabetes. However, we are all at risk. The best sign of insulin resistance is a big belly—a waist circumference (at the level of the waist or half way between the top of our hip bone and our lowest rib) of more than 88 cm in white women or more than ___ in Asian women; in white men the insulin resistance means a waist circumference of more than 102 cm or more than ____ in Asian men. An even better measure is waist circumference divided by height which should be no greater than half (0.5%).The best ways to prevent insulin resistance are to be physically active (at least a half an hour of moderate exercise a day) and to avoid simple sugars (candy, sugary drinks, desserts). An inexpensive medicine called “Metformin” can be prescribed to help our insulin work better and to decrease inappropriate hunger.