Insulin & Insulin Resistance 101

People who suffer from most of the chronic diseases common in the current century (cardiovascular disease, diabetes, strokes, Alzheimer’s, many cancers, and even COVID-19!) have one thing in common: insulin resistance. 
All of these bad outcomes are caused by an imbalance of insulin, a storage and growth hormone that is absolutely vital to human life.
Insulin resistance is not an easy concept to grasp, and to understand it we need to start with the basics: we first have to understand how the hormone insulin works. 


Insulin is secreted primarily when we eat carbohydrates. While fat and protein can mostly go straight from the bloodstream into our body’s tissues, carbohydrates—which are broken down into smaller molecules such as glucose—can not do the same. They require insulin to ‘open the door’ and let the glucose in. 
When I eat an avocado, my body’s tissues can utilize the fat and protein without secreting any additional insulin. But a potato (for example) is made mostly of carbohydrates. Most of it will be broken down into glucose, and the glucose in my bloodstream cannot be utilized unless I also have insulin to let glucose in.
Insulin allows the glucose in the bloodstream to be used by the body however it is needed. This glucose is primarily harvested immediately as energy. If the body doesn’t need more energy, leftover glucose is sent to the liver for storage as glycogen, which is basically just a chain of glucose molecules kept as an energy reserve. Finally, when glycogen stores are full, the glucose is converted to fat and shipped out of the liver to be stored in fat cells. Insulin helps with this last step, too, opening the door for fat to enter fat cells.
Between meals, the process is reversed. Insulin production decreases as we have finished storing.  Now, the decreasing levels of circulating insulin are an indication to start using our reserves,  the glucose first and then the fat that was previously stored.  The balance between storing and using energy is critical for health.

Insulin Resistance

Unfortunately, the modern Western eating pattern (or “Standard American or Israeli Diet”) causes this entire process to go haywire. The problem is that when you eat a diet full of carbohydrates, especially sweets and refined starches, you flood your bloodstream with more glucose than it was ever designed to handle.  This is made much worse by the presence of fructose, which is present in one way or another in everything that is bought in a package. All of this is further compounded by our consumption of refined processed seed oils, which were never part of the human diet, and which play a critical part in creating insulin resistance.    As a result, insulin production spikes up and can grow out of control. Eventually, your swamped cells become resistant to insulin, dulling its effect. This doesn’t happen for all of insulin’s functions at the same time—for example, the fat cells remain very sensitive to insulin, which makes them greedily accept more energy, even as other tissues are failing to respond.
In the earliest stages of insulin resistance, you (and your doctor) are unlikely to be aware that anything is even happening. At this point, the pancreas is still able to secrete extra insulin in order to overcome a mild degree of insulin resistance, enough insulin, that is, to let the glucose into your cells and return blood sugar levels to a normal level. Everything looks normal to the doctor because the blood sugar is normal.  But is this normal? No! It took a lot of insulin to get that sugar into the tissues. Over time, insulin levels remain higher during and immediately after meals, but also between meals and overnight. All of that insulin disrupts the healthy cycle which is supposed to release fats for energy when we need it between meals. Instead, insulin resistance puts us into storage mode all the time. Gone is the important balance between using and storing. We are always storing fat, even when we are not eating, which just makes us even hungrier. This is a vicious cycle that usually just gets worse and worse.
While we are still trying to figure out the precise complex mechanisms that explain insulin resistance, we know that it’s a state where the body is saying: “STOP! I don’t want any more storage! I have enough!”
The result of insulin resistance is not in dispute. It’s an unhealthy condition that tends to get worse over time, leading eventually to obesity, hypertension, diabetes, and a dizzying number of other dangerous complications. Next time we will discuss what are the symptoms of insulin resistance…how do we even know if we have it.

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