Insulin Resistance

Last week, I have elaborated what takes place in our body when we take too much carbohydrate and the effect on our insulin. The cycle of sugar spikes mentioned last week's article cannot go on forever. Each time it happens, the body is stressed. In response, the body puts out anti-stress hormones from the adrenals called cortisol. In time, the adrenals becomes exhausted from this production, just as the pancreas is exhausted from the constant insulin output which it is not able to keep up with.

A metabolic dysfunction is created. The pancreas takes a beating and ultimately becomes exhausted. When this happens to the pancreas, the amount of insulin secretion is reduced and resulting high blood sugar rises out of control, creating a condition called adult onset diabetes mellitus (also called Type 2 diabetes) that affects may be more than two to three million Malaysians, especially in States like Kelantan, Terengganu , Kedah, Perlis and to a certain extend Selangor and Johor , when in the U.S.A over 16 million of their population is affected by this. Considering that they have over 300 million people, 16 million is pretty low compared to our 3 million of 25 million population !

While the pancreas is being stressed, the adrenal glands are also becoming exhausted from putting ever increasing amount of cortisol needed to raise blood sugar from the transient hypoglycemic episode after each high carbohydrate meal The result is adrenal exhaustion. The production of cortisol and a wide variety of sex hormones, including progesterone, is reduced as well. The symptoms include chronic fatigue, hormonal imbalance, estrogen dominance, and reduced sex drive, among many other symptoms.

But before we get to this stage of exhaustion both in the adrenals and the pancreas, the cell has a self-protecting mechanism in place. It has an internal braking mechanism. This is a protective function to avoid the toxic effects of high insulin and high sugar. The cell is trying to close itself from the entry of sugar and glycogen. In other words, the cell, when flooded with insulin chronically, start to down-regulate itself and start shutting itself off from responding to insulin.

Their receptor activities and the number of receptors decrease so they don't have to deal with the undesirable insulin effect. Instead of following insulin's instruction to allow sugar into the cell, they refuse to listen to insulin's command and keep the sugar out. In this state, the blood insulin level is high as the pancreas is on an overdrive to produce more insulin. The blood sugar level is also high as the cells refuse the entry of sugar. This state is called insulin resistance. It is the fundamental a metabolic dysfunction, and may be considered a pre-diabetic state. This state of insulin resistance alone, evidenced by a high blood sugar level and high blood insulin level, is commonly known as Syndrome X or Metabolic Syndrome, is accompanied by other hyperinsulinemia symptoms such as high blood pressure, high LDL "bad" cholesterol, low HDL "good" cholesterol, and high triglyceride. However, it is important to note that not all people who have high insulin and high blood sugar level have Syndrome X.

The difference between adult onset diabetes mellitus ( also called Type 2 diabetes) and insulin resistance is simple. The key problem leading to type 2 diabetes is insulin resistance coupled with the inability to secrete enough insulin to overcome that resistance. The blood sugar level is high due to insufficient insulin. With insulin resistance, both blood sugar levels and blood insulin levels are high. Type 2 Diabetes is the end stage result of metabolic dysfunction in the processing of sugar in our body.

Cellular Response to Insulin Resistance
Different cells respond to insulin differently. Some cells are more resistant than others, as some cells are incapable of becoming very resistant. The liver becomes resistant first, followed by the muscle tissue and lastly the fats.

The sugar in our blood is determined by the amount we eat from our diet and the amount of sugar from the liver. During the night, in the case of insulin resistance, the liver is putting out sugar as a way to keep the body going, as it is not listening to the command of insulin. In the morning, the fasting blood sugar is therefore elevated. In the muscles, insulin resistance means that sugar is not transported into the muscle cells for metabolism and energy generation. More sugar is therefore outside, further contributing to an increase in blood sugar.

The more you expose the cell to insulin, the more the cell becomes insulin resistance in a bid to protect itself. This process progresses through life as our cells progressively become more insulin resistant. It cannot be avoided, and that is why one of the prominent signs of aging is insulin resistance. Those who are able to reduce the rate of insulin resistance will live longer. In order words, the rate of insulin resistance determines our rate of aging.

As you can see, if you wish to remain young and healthy looking, better start to take care of the food that you eat !