Are You Insulin Resistant?

Do you feel tired and sluggish all the time? When you try to lose weight, do you get so hungry that your hunger defeats all your efforts to stay on a diet? Have you been gaining weight and can’t seem to get it off? If these conditions apply to you, you could be Insulin Resistant. And if you are insulin resistant, you are at risk for both morbid obesity–that’s weight gain so extreme that it threatens your life–and developing Type 2 Diabetes.

What is “insulin resistance?”

Insulin is the hormone “key” that unlocks your body’s tissues, enabling them to utilize as fuel the glucose or sugar that is in your blood from digestion of the foods you eat. This ability to remove sugar from the blood and convert it to fuel is vital to a healthy body. Your muscles need sugar to function, and so does your brain. When you are insulin resistant, your body’s tissues “resist” the insulin’s attempt to metabolize the sugar into a usable fuel. Even though your body is starved for the sugar it needs for fuel, it is unable to use the available sugar in your blood. So instead of being used as fuel, the sugar builds up in your blood, which causes many serious health problems.

What causes insulin resistance?

Insulin resistance develops over time from an unhealthy lifestyle and bad eating habits. Too much fast food and chemical-laden processed food, combined with stress, insufficient sleep and a lack of exercise, starts to take its toll. A diet lacking in fiber, complex carbohydrates, fresh fruits and vegetables further deprives your body of the resources it needs to recover from the poor diet and unhealthy habits.

Why is insulin resistance a problem?

If your body is unable to get rid of the sugar in your blood by burning it as fuel, blood sugar can rise to dangerously high levels. Prolonged levels of elevated blood sugar cause “bad” cholesterol to soar and your blood pressure to shoot up. Left uncorrected, your body’s inability to use insulin can bring on the onset of diabetes, causing nerve and circulatory damage that may lead to heart attacks, strokes, kidney failure and blindness.

When your body tissues become resistant to insulin and blood sugar levels begin to rise, your pancreas responds–as it is programmed to do–by producing and releasing still more insulin. Too much insulin in your blood has two very undesirable side effects: it makes you feel hungry (because your body is literally starving for fuel), and attempts to neutralize the excess sugar by causing your body to store it as fat! No wonder your every attempt to lose weight ends in failure!

Worst of all, if this “insulin resistant” condition continues for too long, your pancreas can simply become exhausted from producing all that insulin and greatly reduce its output, or stop altogether. When that happens, it causes the condition known as diabetes. Diabetes simply means your body does not produce enough insulin. Without insulin or medication to activate the processing of sugar in your body’s tissues, the sugar simply builds up in your blood–causing the destructive nerve and circulatory effects described above.

What can I do to reverse insulin resistance and prevent diabetes?

The good new is that just because you’re insulin resistant doesn’t mean you are doomed to become a diabetic. If you make changes to your diet and lifestyle now, you can reverse the process and your body will again accept and utilize insulin the way it should to keep your blood sugar levels within safe, normal range.

Diet and exercise are the key to making this happen! (You knew I was going say that, didn’t you?) Exercise is the number one, best way to increase your body’s sensitivity to insulin! Your muscles are fueled by sugar. When you exercise, your muscles are less resistant to the action of insulin and allow the sugar to be utilized as the fuel they need to meet the demands placed upon them by the exercise. A combination of aerobic exercise–such as walking–and strength training–working with small weights to increase muscle mass–has proven to be the most effective combination to combat insulin resistance or lower your blood sugar levels, if you are already diabetic.

And yes, diet is important, but how you diet is even more important! Simply cutting calories or eating less just doesn’t work, if you are insulin resistant, because that does nothing to correct the over-supply of insulin. What DOES work is paying attention to the “glycemic index” of the foods you eat, to avoid dumping a large amount of sugar into your blood all at once. Since the presence of too much sugar in your blood is what triggers the excess insulin –starting the hunger/fat storing cycle all over again-the key is choosing foods that digest more slowly and release sugar more gradually.

What is the “Glycemic Index?

Put simply, the “glycemic index” of a given food is a number assigned to that food, based upon how fast it turns to sugar in your blood, when it’s digested. Most foods, when digested, are broken down to sugar, since that is your body’s primary fuel. But the conversion to sugar happens much faster with some foods, than with others. In general, “white” foods have a high glycemic index, meaning they will very quickly turn to sugar in your blood, triggering the undesirable flood of insulin. These white foods include white bread, potatoes, white rice and (go figure!) white sugar. All of these are “simple” carbohydrates-meaning they are easily digested.

The “glycemic index” is an excellent tool to help you learn what foods to eat to avoid the excess insulin that will sabotage your efforts to lose weight. Once you get the hang of it, though, you won’t need to count “glycemic points” for the rest of your life to make this work. Just remember that instead of simple carbohydrates that will quickly turn to sugar in your blood, you need to eat complex carbohydrates that digest more slowly, thus slowing the accumulation of blood sugar and avoiding the excess insulin trap.

Instead of white pasta, eat whole wheat pasta. (It looks “brown” before it’s cooked, but once it’s cooked and paired with sauce, it’s hard to tell the difference!) Instead of white bread, find a good, whole-grain bread you like, and eat that, instead. Instead of orange juice–which is high in sugar and is transformed almost instantly into sugar in your blood–eat the whole orange. The fiber in the orange will slow the arrival of the sugar in your blood. So: eat complex carbohydrates like whole-grain pasta, whole-grain breads, beans and lentils. (Like split pea soup with a little ham for seasoning? That’s an excellent choice of a lower glycemic index food! Fresh fruits and veggies are good, too.) Mixing these more complex foods with protein slows the breakdown into sugar even more.

And here’s the best part: If you follow this method of eating, you’ll find those hunger pangs will soon fade and disappear. You’ll stop storing fat and start losing weight, and you’ll feel great! If you simply must have one of those “bad” high glycemic index foods, combine it with one of the complex foods described above. This will help to slow down how quickly the sugar from that “bad” food will hit your blood, thus avoiding the unwanted “insulin spike”.

Moreover, this is a very healthy diet–one that’s safe to use indefinitely–and one that’s so easy to live with you can stick with it! You need not starve yourself or live on lettuce leaves and celery. You’ll find that you can eat real food in reasonable quantities and still lose weight! A couple of cautions, though: One thing you will want to count is how many grams of fat you’re consuming. To lose the fat you’ve accumulated over time, you need to eat less fat than your body needs, so it will be forced to start burning up the fat you’ve stored. Portion size is important, too. Regardless of what the ads for some “diet aids” tell you, you can’t eat unlimited amounts and expect to lose weight. But if you stay on this diet for a week or two, you’ll find that you can eat smaller portions and still feel satisfied. Add exercise to your diet plan to lose weight even faster, and further reduce the “insulin spikes” that sabotage your efforts.

If you want more information, there are numerous books on the subject–many containing recipes using low gycemic index foods, and providing much more information about the subject.

Note: This article is a general guide to healthier eating. It is not offered as medical advice, nor should it be used as such. Please consult your physician before starting any diet or exercise program.

Treating Diabetes – Understanding Insulin

“Insulin” is commonly used as a generic term for a multitude of different types of insulin that are available. When you shop for a new “car,” you may come home with an SUV, a pick-up truck, a sports car, a sedan, or a minivan. All these different “cars” have a different function, just as different types of insulin have different effects.

Insulin has been used since the 1920s in the treatment of diabetes. Initially, purified pork and beef insulins were utilized; however, patients could develop antibodies or symptoms of an allergic reaction to these “foreign” substances. Consequently, human insulin was developed for pharmaceutical use in the 1960s. The 1990s saw the development of genetically altered “analog” insulins; these have become the standard of care today.

When considering insulin therapy, we need to look at these three factors:

  1. The onset of action of the insulin, meaning how quickly does the insulin begin to work?
  2. The duration of action of the insulin, meaning how long does the insulin work?
  3. When does the insulin peak, meaning when is the insulin working its hardest?

We place insulins into four categories, based on how long they are effective. These categories include:

  1. Rapid-acting insulins have an onset of action within 15 minutes, peaking in 1 to 2 hours with a duration of 3 to 4 hours.
  2. Short-acting insulins have an onset of action in 30 to 60 minutes, peaking in 2 to 3 hours with a duration of 4 to 6 hours.
  3. Intermediate-acting insulins have an onset of action in 4 to 6 hours, peaking in 10 to 12 hours with a duration of 14 to 18 hours
  4. Basal (or baseline) insulins are long-acting, with an onset of action in approximately one hour. They are characterized as “peakless” insulins, but truly have a small peak at approximately 10 hours, with a duration of up to 24 hours.

A number of premixed insulins are also available on the market. They are combinations of either rapid- or short-acting insulin with intermediate-acting insulin. The three combinations available include:

  1. 25% rapid-acting insulin and 75% intermediate-acting insulin
  2. 30% rapid- or short-acting insulin and 70% intermediate-acting insulin
  3. 50% rapid-acting insulin with 50% intermediate-acting insulin

The older human insulins that are still available and used today are short-acting and intermediate-acting insulin. These human insulins vary significantly in their day-to-day action within the same person, producing a higher incidence of hypoglycemia. Their peak is such that it requires the patient be eating at the time of peak action to prevent the onset of hypoglycemia. I limit the use of these insulins, believing that the patients who take them are “working for their insulin,” rather than “having their insulin work for them”.

The newer analog insulins have much less variability from day-to-day. They are often used in basal-bolus therapy, or what I like to refer to as “baseline-mealtime dosing with multiple daily injections.” This will generally require four or more injections a day in order to control before- and after-eating glucoses with a much lower incidence of hypoglycemia than the older insulins.

Insulin – A Beginner’s Guide to The Basics

You just received the news that your doctor is adding insulin to your diabetes treatment plan. The use of insulin to control your diabetes can be confusing and intimidating. It doesn’t have to be. Using insulin is a positive experience because it helps you to manage your diabetes.

The first thing to remember is that insulin is not a punishment in any form. If you are using insulin, it is because insulin is absent from your body, or your body still makes insulin but it is not enough. Sometimes oral meds are no longer working, so insulin is added to your treatment plan. Your doctor will discuss your dosing requirements with you.

Insulin injections are nothing to be afraid of, even for people that are fearful of needles. Modern technology has made the needles so small and thin that the insulin injection is rarely felt. Used correctly in conjunction with your meal plan and exercise, insulin can give you excellent control.

There are many different guides on how to self administer an insulin injection, so this topic won’t be covered in this guide. The basics of using insulin are simple, and require knowledge of how insulin works which your doctor should explain to you. Insulin use also requires knowledge of insulin delivery systems, and insulin supplies that will help make your life with insulin a breeze.

Insulin delivery

Insulin delivery systems are a matter of need and choice. Insulin users that have insulin pumps as their delivery system have much different guidelines that won’t be covered here. The focus of insulin delivery systems for this article will be on syringes, insulin pens, jet injectors and inhaled insulin.

Dosage amount and syringe size

Insulin syringes and needles come in different sizes. The amount of your insulin dose determines the size of the syringe that you will need to use. If you are taking 30 units or less, a 3/10 cc (30 unit) syringe will work. If you are taking 31 to 50 units, 1/2 cc syringe (50 unit) will be needed. If your dose is 51 units or more, a 1 cc (100 unit) syringe will be necessary. The needle sizes vary for each syringe size. Syringes may be purchased from a pharmacy.

Insulin syringes are disposable, and should be discarded after one use. A bio hazardous container such as a sharps container will be needed to hold discarded syringes. These containers can be obtained from some waste disposal services, and may purchased from any pharmacy. Disposal of sharps containers requires special handling. Your doctor, diabetes educator, or pharmacy should be able to tell you where sharps can be disposed of in your area.

Insulin Vials

Liquid insulin comes in vials and insulin pens. Vials are stored in the refrigerator until use, and are discarded after the insulin is used up, or after 28 days, whichever comes first. Vials hold various amounts of insulin depending on the brand. Insulin is drawn up into the syringe from the vial and can be injected into several areas of the body, usually the thigh or abdomen. Most types of insulin require a prescription.

Insulin pens

Insulin pens are a convenient way to administer insulin. An insulin pen looks like an oversized ink pen, and uses disposable needles. There are two different types of pens. One type is prefilled with 300 units of insulin. The prefilled pen is discarded after the insulin is used up or after 28 days, the same as for vials. The other type uses insulin cartridges, and the cartridges are changed using the same schedule that is used for prefilled pens. Insulin pens are not refrigerated after the first use.

Needles for the insulin pens come in different sizes. Insulin dosages are dialed on the pen in one-half and one unit increments depending on the type of pen used. The result of dosing by pen is fewer dosing errors. Insulin pens are handy, and allow easy dosing for people on the go. Pens are also discreet. It is not recommended that pen needles be used more than once for the same reasons that syringes should not be reused; bacteria and possible infection. Pen needles should be discarded in a sharps container.

Another insulin delivery device that falls into the insulin pen category is called the InnoLet. This device looks like a kitchen timer with a big dial. The InnoLet holds 300 units of insulin and is very handy for people with visual difficulties.

Jet Injectors

Jet injectors release a tiny stream of insulin through the skin by using a mechanism that creates high-pressure air. The injector doesn’t use a needle. After the insulin dose is loaded into the injector, the injector is placed against the skin and a button is pressed to release the insulin into the skin. Jet injectors are not very popular among insulin users due to bruising and other factors.

Inhaled Insulin

Exubera, the only insulin that is inhaled, was approved for use by the FDA in January of 2006. Your doctor will advise you if inhaled insulin is an alternative for you to use to treat your diabetes. Exubera comes packaged as a dry powder in blister packs, and the packs are loaded into an inhaler. The insulin is inhaled into the lungs. This method of insulin delivery has some restrictions that should be discussed with your doctor.

Diabetes supplies

After you decide which insulin delivery system you will be using, a carrying case will be needed to carry your insulin, meter and other necessary items. A multitude of diabetes products are on the market to accommodate your needs. Choosing the right products will make the time that you spend on diabetes management more productive. The best way to locate diabetes products is to search for them online, or look in diabetes magazines.

It is important for insulin users to carry a meter and glucose tablets at all times. Insulin can cause “lows” which can lead to unconsciousness if not treated promptly. Insulin users also have to test more frequently than non-insulin users.

Now that you have the insulin basics, you should be confident that you can use insulin proficiently and painlessly as part of your treatment plan. Discuss with your doctor which insulin delivery method is best for you, and start on the road to better diabetes control.

© Copyright 2007 Patti McMann. All rights reserved.