Insulin resistance: what is it?

Insulin resistance is on the rise, and so are people’s waistlines. The ‘obesity epidemic’ is, in fact, an epidemic of diabetes, metabolic syndrome and cardiovascular disease – conditions that put undue strain on healthcare systems even before the Covid-19 pandemic.

Why ‘‘undue’? Because insulin resistance itself, the physiological phenomenon at the heart of diabetes, metabolic syndrome, cardiovascular disease and obesity, is completely 100% treatable using only diet and lifestyle practices. Yup – you don’t even need herbs. And when a herbalist says that, you know there better be a good reason for it.

Diabetes and insulin resistance
Before we move on, let’s take a look at one alarming statistic. The International Diabetes Federation estimated in 2017 that the number of people with diabetes globally had increased from 108 million in 1980 to 422 million in 2014 – that’s a 290% increase. These numbers are only expected to increase by 48% by 2045, roughly the same time period.

It must be clear that the global shift towards a Western diet high in sugar and fructose, coupled with a more sedentary, high stress lifestyle, brought about this huge initial increase in diabetes incidence. In turn, it must be clear that in order to reverse the numbers, we need to exercise, eat and live a bit differently.

The alarming thing is that even more people are walking around with ‘prediabetes’ – a state of insulin resistance, sometimes called metabolic syndrome or ‘syndrome X’ – and they don’t even know it. In 2018, as many as one in three adults in the United States were thought to be insulin resistant – most of these will go on to develop full-blown diabetes.

So, what is insulin resistance?

The lowdown on insulin
We need insulin not only to transport sugars from the bloodstream into the cells, but also to carry across vitamins, amino acids and essential minerals. When the blood becomes nutrient-rich after a meal, the pancreas secretes the hormone insulin in response – think of it like a key that unlocks the cell, allowing nutrients and sugars to flow in.

In this high-insulin environment – called ‘hyper-insulinaemia’ – the body is focussed on burning sugar, not fat. Elevated insulin prompts the secretion of IGF-1 (insulin-like growth factor 1) from the liver, which puts the body into an anabolic (growth) state and, in turn, shuts off growth hormone (GH) secretion. GH promotes the building of lean muscle mass and the burning of fat – so, for as long as insulin is coursing through our arteries, the prevalence of IGF-1 means that we cannot burn fat or build lean muscle.

Back in our hunter-gatherer days, carbs consisted of 22-40% of our total calories – nowadays, Americans consume 50-60% of their total calories as carbs. This shift towards a carb-heavy diet means the pancreas has to keep pumping out insulin in response. Eventually, like any other hormonal system in the body, overstimulation of insulin receptors – the lock that the key needs to open the cell – causes them to malfunction. Receptors start dying off, or not responding to insulin – they become ‘desensitised’ or resistant to it.

After a carb-rich meal, insulin is typically elevated in the blood for 2-3 hours in a non-insulin resistant person – but in someone who has been ‘desensitised’ to the effects of insulin, it sticks around for much longer. And if someone is consuming carbs at every meal – cereal or oatmeal in the morning, bread for lunch, a sweet snack mid-afternoon and dessert after dinner – they will be under the effects of insulin, i.e. not being able to burn fat or build lean muscle, all day long and into the night.

Not all cells respond to insulin in the same way – some are starving, which makes the person eat even more carbs, and some become overfed and inflamed, such as the blood vessels, leading to heart disease. Hyperinsulinaemia also strips the body of essential nutrients such as chromium, magnesium, zinc and B vitamins, as these are required for insulin to bind to cells and do its work. This adds to a picture of an overfed individual who is “starving at their core”.

What to do about it?
This all sounds pretty complex, but in terms of treatment, it really isn’t. Stay tuned next month for an overview of how to overcome insulin resistance in three simple steps, using nothing but diet and exercise.

By Poppy Burr
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Poppy is a UK-trained medical herbalist practising in Praia da Luz. She offers consultations and treatment in Western Herbal Medicine, incorporating Functional Medicine testing and nutritional strategies where appropriate. For more information, visit