Signs You May Have Insulin Resistance

Chances are, if you watch TV or like scrolling through social media lately, you have likely seen an ad or commercial about the importance of balancing your blood sugar. You have also likely heard the phrase “ insulin resistance”. But, what is insulin resistance really and why is addressing it so important, especially in women? 

Well, before we jump into what insulin resistance really means, we need to first understand what insulin does. Insulin is a hormone that is part of your endocrine (hormonal) system and is involved in controlling the amount of sugar (glucose) found in your bloodstream. Glucose is an important molecule that serves as an essential form of energy for a variety of cells, including your muscles, liver and fat cells. In order for these cells to take in glucose, insulin helps direct glucose from the blood to these important cells. This glucose can either be taken up as a form of energy or it can be converted into fat, for later use. Insulin is also involved in a variety of metabolic processes including the breakdown of dietary fats and proteins. Unfortunately, insulin resistance occurs when cells in your muscles, fat and liver no longer respond to the stimulates insulin is providing.  This prevents these important cells from uptaking glucose for energy. Instead, that glucose remains trapped in the blood, leading to high blood sugar levels, and eventually, can develop into what is known as Type II Diabetes Mellitus. 

Insulin resistance has not only been linked to the development of diabetes, but due to insulin’s role in a variety of metabolic processes, it has also been linked to hypertension (high blood pressure), dyslipidemia (abnormal lipid control), as well as, cardiovascular disease. The reason identifying and treating insulin resistance is so important is because it can often develop long before these diseases are ever detected or diagnosed. Which means, if we can take a proactive approach to your insulin levels, we could help you reduce your risk of ever developing conditions like diabetes, hypertension and cardiovascular disease. Although this is an extremely exciting way to prevent long term disease, routine  testing is often not part of your annual physical exam or workup. This is where being an advocate for your health is extremely important and may help you avoid the development of lifestyle based medical conditions. In other words, a simple blood test done annually could help you avoid the long term implications of conditions like diabetes. Did I mention that the average cost of testing a fasting insulin is usually less than $25! This is an extremely affordable test that could provide significant insight on your health and improve your quality of life. 

Although at NMD Wellness of Scottsdale, we believe that everyone should be evaluated annually for insulin resistance, there are a few important risk factors to mention that may increase your risk of developing insulin resistance. 

Insulin resistance should be suspected in patients who have: 

• First-degree relatives with a history of diabetes 

• Personal history of gestational diabetes 

• Polycystic Ovary Syndrome (PCOS) 

• Obese patients, particularly those with abdominal obesity. 

• Sedentary Lifestyles 

• Diets high in processed foods and carbohydrates 

• Conditions like nonalcoholic fatty liver disease 

• Smokers

• Those taking medications like steroids, antipsychotics and HIV medications 

• Sleep problems including sleep apnea. 

Unfortunately, since insulin resistance can show up months to years before the development of diabetes, it often can show up with limited symptoms. That being said, if you have elevated blood sugar levels (fasting glucose and/or fasting insulin), have elevated cholesterol, especially high triglycerides, high LDL (“bad”) cholesterol and low HDL (“good”) cholesterol, your health care provider should suspect insulin resistance.

 In women, especially those with PCOS, we may also see particular symptoms including: food cravings (sweets and salt containing foods), darkening of the skin in the groin, armpits or behind the neck, an increase in skin tag, as well as, fatigue and frequent or increased urination. 

Insulin resistance, should also be suspected if you have the following: 

• Waistline over 40 inches in men and over 35 inches in women 

• Blood pressure readings of 130/80 or higher 

• Fasting Glucose over 100mg/dL 

• Fasting triglycerides over 150mg/dL 

• HDL cholesterol under 40mg/dL in men and 50mg/dL in women 

• Skin tags 

• Patches of dark, velvety skin (known as acanthosis nigricans) 

So, how is insulin resistance treated and is there anything you can do today to avoid it from occurring in the first place? I’m so glad you asked. 

The short answer is, YES! Absolutely. Some of the most important first steps in improving insulin and glucose control and reversing your risk of diabetes comes down to diet and lifestyle modifications. Making exercise a top priority is one of the best ways to reduce and/or reverse insulin resistance. Aiming to exercise 15-20 minutes 7 days a week has made a significant impact in our patient’s ability to reverse their insulin resistance. Although, you may have previously heard that working out for 45-60 minutes, three times a week was best, the reality is our patients are able to stay much more committed and consistent to long term exercise when it is done each and every day. Consider it your “non-negotiable”. Just like many of you likely can’t start your day without coffee, start making exercise a non-negotiable for your day. 

Another important way to reduce your risk of insulin resistance is to maintain a healthy weight. Although adequate exercise and a healthy diet is an important way to maintain a healthy weight, if you suffer from other medical conditions including PCOS, you may need additional guidance and support for proper weight loss. This may include working directly with your doctor, nutritionists and/or certified personal trainer. 

Eating a whole-foods diet with anti-inflammatory properties has also been an extremely successful way for our patients to combat insulin resistance. Focusing on incorporating healthy omega-3 rich fats and between 15-20 grams of protein per meal, is not only important to help you avoid feeling hungry or eating “empty calories” but, it is an extremely important way to maintain your blood sugar throughout the day. Once you have added healthy fats and protein to your meal, make sure to incorporate vegetables with every meal and avoid consuming any and all processed foods, even those listed as “healthy” food alternatives. Stick to the basics and focus on a whole-foods based diet. 

Once you have created an active lifestyle and you are making your diet a priority, the next step we may consider is additional nutritional, supplemental and/or pharmaceutical interventions. This will absolutely be determined by your doctor on a case-by-case basis. Your doctor may consider prescribing medications like Metformin, or may consider the addition of supplements, like Berberine. Berberine has recently been shown to have significant improvement in lipid and glucose metabolism, especially in patients with PCOS and has been shown to be as effective as Metformin with potentially less GI related side effects. Again, always consult with your doctor before starting any new dietary or supplemental regimen. 

About the Author: Meet Dr. ZenAlissia Zenhausern- Pfeiffer, NMD, FABNE, (commonly known by her patients as Dr. Zen), is a licensed naturopathic doctor board certified in naturopathic endocrinology and the founder of NMD Wellness of Scottsdale, a premier naturopathic medical practice that focuses on helping women to take a proactive approach to their hormone and fertility health. Dr. Zen has been featured as a lead expert in Forbes, Shape Magazine, and Instyle and is deeply passionate about bridging the gap between traditional and natural medicine in the world of fertility. She works with a variety of hormone related issues including PCOS, endometriosis and unexplained infertility. Her goal is to help more women get back into the driver’s seat of their own health to make lasting transformational changes to their health to bring more cute and adorable babies into this world. Read More About Dr. Zen...