Hello,
It is pretty known that Insulin Resistance is caused by constant spikes in glucose which forces the pancreas to create more insulin which eventually leads to insulin resistance.
Foods that cause high spikes in glucose are high on the Glycemic Index. These includes bagels, sugary drinks, potatoes etc.
When I look at the people around me, they’re constantly eating foods high on the glycemic index or meals with high glycemic loads, yet they seem perfectly fine?
For example, I’ve got a coworker who eats 2 bagels every morning, McDonalds for lunch (fries, sugary drink, and a burger and sometimes gets a pastry). Not sure what he eats for dinner, but he often talks about his pasta or peanut butter rice meals.
How come my coworker wouldn’t eventually develop insulin resistance? He doesn’t have any of the risk factors, though. He’s in shape (healthy weight range) and goes to the gym (but he’s not very consistent)
And when you think about this in a broader sense, a lot of Americans eat foods and have a diet that lead to glucose spikes… so why isn’t there an Insulin Resistance epidemic?
I guess it could be because they don’t meet the other risk factors such as obesity, lack of exercise etc.
Because the glycemic index and “glucose spikes” are not what actually cause insulin resistance, especially by themselves.
We have glucose spikes from eating many healthful things. As long as you’re eating an over all balanced diet, this isn’t an issue. Especially as long as you’re physically active. Its how were designed. We eat- insulin spikes to transport amino acids and fatty acids and glucose into our cells. We stop eating. Glucagon comes in to release amino acids and glucose and fatty acids into circulation to be used for energy. As long as we aren’t abusing that- it is quite literally what is supposed to occur.
Insulin resistance is caused by, overtime, a lack of response to insulin via the insulin receptors in peripheral tissues- mostly adipocytes and skeletal muscle cells. Our blood sugar then stays high, because nothing is transported into our cells. After this issue persists for a long time, the beta cells in the pancreas also experience issues in making enough insulin to keep up with this cycle.
What causes this?Inflammation and obesity, as well as a lack of physical activity. Yes a shit diet does totally factor into creating those issues.
When we have hypertrophy and hyperplasia of adipocytes, they release FFA’s and recruit macrophages via the adipokines. This increases localized inflammation, and also interferes with the insulin receptor being phosphorylated and a downstream cascade of enzymes working to signal GLUT4 (adipocyte and glucose transporter) to allow glucose and amino acids into the cell. So this now isn’t occurring due to adipocytes increasing inflammatory responders.When this happens extensively enough, especially with ectopic and visceral fat (fat in and around major organs) we experience systemic level insulin resistance and dysfunction.Physical activity increases the insulin sensitivity of our muscle cells and helps to counteract this. Maintaining a healthy weight counteracts this. Keeping inflammation low and a well-rounded diet helps this.
So, ideally… if someones not gaining fat and is also eating fiber and fruit and veg and protein and exercising…. insulin spikes in and of themselves aren’t really the exact issue. Carbohydrates are not your enemy, especially if they’re eaten with nutrient dense food. They’re good for exercise too! We just would ideally eat ones with more whole grain and fiber.
We also do still sort of have an insulin resistance epidemic in the sense that 13% of the population has diabetes and another 96 million have pre-diabetes.
Id largely disregard glycemic index, especially if youre not considering load. Overall dietary pattern and habits matter much more and theres a reason why we hardly acknowledge glycemic index as an important variable in nutrition science.
Also: adipocytes even release angiotensin 2 and increase Htn, as well as further increase insulin resistance. Its really amazing what an active endocrine organ they are.
> It is pretty known that Insulin Resistance is caused by constant spikes in glucose which forces the pancreas to create more insulin which eventually leads to insulin resistance.
This isn’t what causes insulin resistance; you’re more on track with your thoughts around risk factors.
When someone is insulin resistant, their cells aren’t responding properly to insulin, and the pancreas has to create more and more insulin in order to try and elicit a response. But what is causing the cells to not respond in the first place???
We don’t even fully understand it, but there are a number of risk factors:
Things like exercise and omega-3 intake are known to improve insulin resistance, so sugar does not tell the whole story.
Sugar is associated with insulin resistance mostly in the context of excess consumption overall, i.e. weight gain. Not all people who carry extra fat go on to develop insulin resistance, so there are more complex mechanisms at play (something leading to malfunctioning of adipose tissue, which causes hormonal imbalances or increases in certain inflammatory signals). Where people tend to carry their fat also makes a difference (visceral, or around the organs, rather than subcutaneous, or under the skin).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038351/>Visceral adipose tissue increases, and subcutaneous adipose tissue decreases the risk of insulin resistance and T2DM in humans.
>Visceral adiposity correlates with excess lipid accumulation in liver.
>Excess accumulation of lipid may cause insulin resistance through cell autonomous mechanisms, and through the induction of inflammation, and the consequent production of inflammatory cytokines.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174139/
> In particular, the most marked effects are observed when a high sugars intake is accompanied by an excess energy intake. This does not mean that a high intake of free sugars does not have any detrimental impact on health, but rather that such an effect seems more likely to be a result of the high sugars intake increasing the chances of an excessive energy intake rather than it leading to a direct detrimental effect on metabolism.
No, no. Intramyocellular lipids in your cells cause insulin resistance.
What happens is the accumulation of intramuscular fatty acids causes an inhibition of glucose transport, so blood sugars remain elevated for longer while simultaneously being unable to get into the places it needs to be. The pancreas then becomes overstimulated to produce more insulin in response to the rising blood sugars, which leads to the “crash” and hypoglycemia episodes.
Chronically elevated blood sugar levels over time can result in permanent damage to parts of the body (eyes, nerves, kidneys, blood vessels). The A1C test is a good diagnostic to determine your average blood sugar over the last 3 months.
T2 is not insulin deficiency. It is high blood sugar caused by insulin resistance. Easily reversible. Eventually, however, the strain on the pancreas can force it to produce less and less insulin, which then necessitates an exogenous supply.
T1, however, is insulin insufficiency due to complete beta cell dysfunction and requires lifelong insulin to compensate. (Until we find ways to regenerate it, which looks promising).
There is an insulin resistance epidemic. Something like 70% of Americans are overweight or obese? And last I checked 10% of the population is diabetic, even more are pre-diabetic, and all of these numbers are projected to keep going up over time. Some people’s metabolism are good enough that you don’t see it happening while they’re young but once they start getting older they gain a ton of weight from eating like that. Others can’t eat that way ever or they become diabetic and overweight very quickly. That’s just genetics. But abusing the body like that will lead to problems eventually no matter how good your genes are
How doesn’t everyone have Insulin Resistance? Fast Facts on Diabetes…
https://www.cdc.gov/diabetes/data/statistics-report/index.html
Diabetes:
Total: 37.3 million people have diabetes (11.3% of the US population)
Diagnosed: 28.7 million people, including 28.5 million adults
Undiagnosed: 8.5 million people (23.0% of adults are undiagnosed)
Prediabetes:
Total: 96 million people aged 18 years or older have prediabetes (38.0% of the adult US population)
65 years or older: 26.4 million people aged 65 years or older (48.8%) have prediabetes
Mostly because you are wrong. Continual spikes in insulin does not cause insulin resistance.
Being overweight and obese causes insulin resistance. You get obese by eating too many calories. Or having some sort of medical condition.
There’s a THEORY that each individual has fat threshold in adipose cells. When you’re above this threshold it will require more and more insulin for glucose transport. That’s why it’s pointless to push more insulin for t2 diabetes if the problem is too much glucose intake
Read The Diabetes Code, it says excessive fructose intake in the modern diet causes fatty liver which leads to insulin resistance. According to the book, if your coworker isn’t slamming enough fructose to fatten his liver then he might be ok, and avoiding snacks would also help. The author would say if he keeps at it with the soda it’s likely just a matter of time.
My diet is not too dissimilar to that of your colleague. I do run regularly but definitely eat far too many sweet things. I got my weight down about 18 months ago through IF but that’s now lapsed and it’s creeping up again. So I got myself a continuous glucose monitor to just see how my body coped with the crap I was shovelling in.. My body seemed to be handling everything fine, then after eating a carb packed dinner I went to bed and woke up in the morning feeling awful. When I checked my readings I’d suffered with hypoglycaemia during the night. This has happened multiple times before but I always put it down to a poor nights sleep. It’s made my really think about what I’m eating and particularly when I’m eating it. I think many people do have insulin resistance, the just don’t know it.
You’ve gotten a few great and detailed scientific responses, but I’ll chime in anyway with a laymens version. First of all, forget the glycemic index. It’s not very useful. Insulin spikes are not the enemy, they are an inevitable consequence of eating and necessary. But insulin resitance is when our cells no longer react to the insulin spike and then our blood sugar stays high. Like a biochemical version of the boy who cried wolf. If we are constantly eating and keeping our insulin levels high, our cells stop listening.
The spacing of meals (and insulin spikes) is very important in order to prevent or treat insulin resistance. Giving our metabolism at least an eight hour block, preferably twelve hours where we don’t eat anything at all, gives our insulin levels, pancreas and liver time to restore and regenerate.
Without needing to calorie restrict per se, making sure you fast for 12 hours out of every 24 has a massive postive impact on your health and wellbeing.