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Sluggish Metabolism and Insulin Resistance

Are you feeling that your metabolism is sluggish and you lack energy? You may have insulin resistance.

What is insulin resistance?

Insulin is a hormone that is produced by your pancreas in response to higher than the ideal range of sugar in your blood. Your blood normally keeps the glucose level in your blood between 4-6 mmol/L. When the blood sugar raises higher than this range, the pancreas will produce insulin. This insulin acts like the key of your cells that allow the glucose to enter your cells for energy production.

Insulin resistance is when the cells in your body (liver, muscles, adipose tissues) do not respond well to insulin in your blood and therefore do not take up glucose from your blood. As the blood sugar remains high, the pancreas will produce more insulin. As long as the pancreas can produce sufficient insulin for the uptake of sugar, the body will regulate the blood sugar to within its ideal range.

Insulin Resistance and Pre-Diabetes

Pre-diabetes usually develops from those who have insulin resistance or when the pancreatic cells cannot make enough insulin. Pre-diabetes is a precursor to developing type 2 Diabetes.

The prevalence of pre-diabetes in New Zealand is around 26% (according to The 2008/09 New Zealand Adult Nutrition Survey (2008/09 NZANS) ). In Australia, this is around 16% of the adult population and in USA, around 34% are pre-diabetic.

Around 50% of those with pre-diabetes will develop type 2 Diabetes.

How can one test for insulin resistance?

Well, there is that costly way of getting a fasting blood test for insulin resistance. This is very costly.There is also a cheat sheet to calculate insulin resistance from your lipid test results that you can obtain as part of your routine medical checkup. Especially if you are overweight or obese. A Cheat Sheet is usually a small piece of paper which is cramped with a whole lot of equations that students can put into the palm of their hands to take into exam.

Well, that fasting blood lipid test that you can get from your GP to test for your cholesterol level has a lot of compacted information about your metabolism, and risk of you developing different diseases.

One of the information you can get out of this routine test is using the fasting Triglycerides and HDL levels. Divide Triglycerides by HDL (TG/HDL) to give a number.

A number greater than 3 is an indicator of insulin resistance. It is also an indicator of metabolic syndrome. Metabolic Syndrome is a cluster of conditions that increase the risk factor for heart disease, diabetes and stroke. However, this calculation may not hold true for those with an African background.

Simple Solutions to Reverse Insulin Resistance

If you have a number greater than three (3), there are things you can do to reverse insulin resistance.

- Exercise regularly

- If obese, reduce weight to ideal weight for height range

- Remove simple carbohydrates from diet such as cakes, biscuits etc and instead, opt for grainy options.

- Get sufficient quality sleep

- Include fruits and vegetables in your diet

- Reduce stress levels.

Want to understand the full progression? Explore how prediabetes leads to chronic kidney disease

Reference:

McLaughton T et al. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003 Nov 18;139(10):802-9.

Hadaegh F. et al.. Triglyceride/HDL-cholesterol ratio is an independent predictor for coronary heart disease in a population of Iranian men. Nutr Metab Cardiovasc. 19, 401–408 (2009).

Sumner A. E., Finley K. B., Genovese D. J., Criqui M. H. & Boston R. C. Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans. Arch Intern Med. 165, 1395–1400 (2005).