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Understanding Insulin Resistance

Megrette Fletcher, M.Ed., R.D., CDCES

By Megrette Fletcher M.Ed, R.D, CDCES, Co-author of Eat What You Love, Love What You Eat with Diabetes  

While the cause is not fully understood, Type 2 diabetes results from a series of problems. The first problem is insulin resistance. Just as it sounds, the fat, muscle and liver cells resist the effects of insulin.

A-key-in-a-door-lock-007Insulin’s job is to open up the cells, like a key opens a door, and let glucose enter. Insulin resistance is almost as if someone changed the locks and didn’t tell the body. The pancreas, the organ that makes insulin, initially compensates for insulin resistance by producing more insulin – making more keys – which results in high insulin levels or hyperinsulinemia. These high insulin levels promote fat storage and inhibit fat burning, which causes weight gain, making the insulin resistance worse.

Eventually, the pancreas “burns out” and stops making enough insulin (keys) to keep up with demand. When this happens, blood glucose levels rise, which can create feelings of low energy and fatigue, prompting a person to be less active and thus driving the cycle of insulin resistance toward a diagnosis of diabetes. 

Many people don’t realize that insulin resistance may be present for five to ten years before they are diagnosed with diabetes. When blood sugars are above “normal,” but not quite at a level to be diagnosed as diabetes, you have prediabetes. Prediabetes occurs when the blood glucose levels are between 101-126 mg/dL before eating or 141-199 mg/dL within two hours of eating. 

If you have been diagnosed by your health care provider as having prediabetes, this means your pancreas has started to lose its ability to make insulin. If there are no changes in your activity or eating, the pancreas will continue to lose the ability to make insulin. When the pancreas looses about 50 percent of its ability to make insulin and blood sugar levels rise to greater than >126 mg/dL fasting or 200 mg/dL after eating your blood glucose levels are high enough to be diagnosed as “diabetic.” 

How mindful eating can help

Study after study has shown that this decline in the body’s ability to make insulin can be changed by eating a balanced diet and engaging in consistent activity. Unfortunately, you may not be sure what a balanced diet looks like or whether you can be consistent with your activity. Adding to your uncertainty might be a past experience that felt unsuccessful. If this is the case, mindful eating could be the cure you are looking for. Yet to fully understand this idea, you have to resist the “quick fix” lure of the diet industry or a radical exercise program, which ultimately are a series of complex rules or restrictions that do not lead to lasting change. Instead, give yourself permission to explore your eating and food choices fully by asking yourself questions. Curiosity is at the heart of mindful eating. If you are not sure what questions to ask, Michelle May, M.D. created the Mindful Eating Cycle which is a series of six questions. They are described on page 11 of Eat What You Love, Love What You Eat with Diabetes. To learn more about the Mindful Eating Cycle, please click here.

Even if you just ask one question, “Why do I eat?”, you may find that this little dose of curiosity can offer a whole lot of answers.  The truth is that you eat for many different reasons! By asking questions instead of telling yourself what you can have (like a 1/2 cup of tuna fish with six crackers), you can begin to unravel your flavor passions and food pitfalls without guilt, blame or shame. Mindful eating isn’t a diet; it is a journey of discovering YOU – your hunger, your likes and how your blood sugar levels respond to your eating, physical activity, and other factors. You may be surprised how becoming curious can change far more than what you are eating; it can change your whole view of health!

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2 thoughts on “Understanding Insulin Resistance”

  1. The bodies of many people with diabetes are fighting a quiet war against the essential hormone insulin. This conflict is called insulin resistance, and while it’s a hallmark of prediabetes and type 2 diabetes, it can also affect those with type 1. Just why a person fails to respond properly to insulin is something of a mystery. But there are ways to make the body more receptive to insulin, which can help prevent or ameliorate diabetes.

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