Category Archives: insulin resistance

Facts About Insulin Resistance in Type 1 Diabetes

I was diagnosed with Type 1 diabetes in 1967. Since then, I have dedicated my life to researching Type 1 diabetes and to helping people with any form of diabetes maintain better control. I suffered from insulin resistance in Type 1 diabetes (after diagnosis) until I committed myself to improving my insulin sensitivity.

Many people have fallen prey to the myth that people with Type 1 diabetes cannot have insulin resistance. This is absolutely not Insulin Resistance in Type 1 Diabetestrue. It is very common for people with Type 1 diabetes to also have insulin resistance. Carla Greenbaum, MD, who is a Member of the Benaroya Research Institute and serves as Director of the Diabetes Research Program and the BRI Clinical Research Center(1), has conducted multiple studies related to insulin resistance in people with Type 1 diabetes. An abstract from one of those studies states:  “Insulin resistance plays a larger role in the type 1 diabetes disease process than is commonly recognized.”(2) It is estimated that one in three people with Type 1 diabetes also has insulin resistance.(3) One study estimated that 25.8 million people in the US have Type 1 diabetes and insulin resistance; and that insulin resistance plays a large contributing role in the complications associated with Type 1 diabetes.(4) The phenomenon of people having both Type 1 diabetes and insulin resistance is sometimes referred to as “double diabetes” or “Type 1.5 diabetes.”

Sadly, many people with Type 1 diabetes do not believe it’s possible for them to have insulin resistance. This lack of knowledge and refusal to accept the truth can greatly inhibit their ability to control their blood sugars. Their lack of knowledge stems from the insistence that Type 1 diabetes and Type 2 diabetes have nothing in common. Although the causes of each type of diabetes are different, Type 1 and Type 2 have more in common than many people realize.

Before I go further, let’s review the three basic types of diabetes. There are others, but these are the most common:

Type 1 Diabetes:  An autoimmune condition characterized by insufficient insulin production due to the body attacking the beta cells in the pancreas which produce insulin. Type 1 diabetes used to be known as “juvenile onset diabetes” or “insulin dependent diabetes.” Neither of those terms is accurate in today’s world where adults are often diagnosed with Type 1 diabetes and where people with Type 2 diabetes often require insulin to maintain normal glucose levels.

Type 2 Diabetes:  A chronic condition characterized by the body’s inability to properly use insulin. The body’s inability to correctly absorb and use insulin results in high blood sugars and many of the same side effects as Type 1 diabetes. Type 2 diabetes has many other names, most of which are outdated and inaccurate.

Latent Autoimmune Diabetes in Adults (LADA):  A slowly progressing form of diabetes in which the beta cells in the pancreas are slowly destroyed due to an autoimmune attack. Destruction of the pancreatic cells usually occurs much more slowly than it does in Type 1 diabetes, with the patient often not needing insulin for months or even years. Type 1 diabetes and LADA are very similar and have very similar control protocols once someone with LADA progresses to the point of needing insulin.

It is very true that insulin resistance is a characteristic of Type 2 diabetes, but it is also a characteristic of Type 1 diabetes. People with Type 2 diabetes develop insulin resistance before they are diagnosed with Type 2 diabetes; people with Type 1 diabetes usually develop insulin resistance after they develop Type 1 diabetes. Insulin resistance in Type 1 diabetes is very common, but there are ways to reduce its effects.

Symptoms of Insulin Resistance in Type 1 Diabetes

The following symptoms may indicate insulin resistance in someone with Type 1 diabetes:

  • Elevated cholesterol and triglyceride levels
  • High blood pressure
  • Weight gain not associated with an increase in food or decrease in exercise
  • Needing increasing amounts of insulin to maintain normal glucose levels
  • Elevated liver enzymes:  High insulin levels are known to impair the liver’s ability to metabolize glucose, which may result in elevated liver enzymes in blood work.(4)
  • Coronary artery disease

It is somewhat interesting that many of the complications we associate with Type 1 diabetes may actually be caused by excessive use of insulin. Maintaining blood sugars as close to normal as possible is imperative, but there are things we can do to help reduce our need for insulin. My goal in my own control and when I work with clients who have Type 1 diabetes is to improve health by living a lifestyle that improves glucose control, lowers A1C levels, and requires less insulin to maintain normal glucose levels.

Potential Causes of Insulin Resistance in Type 1 Diabetes

The following reasons explain why people with Type 1 may develop insulin resistance:   

  • Stress and illness:  Stress and illness can cause temporary insulin resistance in anyone, but the effects may be much more noticeable in a person who has Type 1 diabetes and is checking blood sugars frequently. This is one of several reasons people with Type 1 diabetes typically need significantly more insulin during times of illness or stress.
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  • Large insulin requirements:  A healthy pancreas produces 20-25 units of insulin each day. Many people who are clients of mine were taking 100-300 units of insulin daily when they first came to see me. I was taking more than 100 units of insulin daily when I began making lifestyle changes to control my blood sugars better. I now take 20-25 units of insulin daily and maintain A1Cs below 6.0. The high amounts of insulin my clients took were required to maintain blood glucose levels as close to normal as possible. The problem is that high insulin usage can have many negative side effects and can cause the body to become “overwhelmed” with insulin and stop absorbing it properly. This results in insulin resistance. Sadly, insulin resistance is very common in people with Type 1 diabetes. For more information in insulin, please read:  Surprising Facts About Insulin. The challenge is that maintaining normal blood glucose levels is essential, even if it requires large amounts of insulin. I’ll share more about effectively addressing that challenge later in this post.
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  • Ethnicity:  People with Type 1 diabetes who are African American, Eskimo, Asian or Hispanic typically have higher rates of insulin resistance than Caucasians with Type 1 diabetes. This is why people of the above ethnicities often require much higher amounts of insulin.
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  • High levels of insulin-binding antibodies:  It is common for people with Type 1 diabetes to have higher levels of insulin-binding antibodies than people who do not have any form of diabetes. (Insulin-binding antibodies are not the same antibodies that attack the beta cells in the pancreas.) Insulin-binding antibodies prevent the body from absorbing insulin and/or neutralize the insulin. This causes people with extremely high levels to require more insulin to maintain normal blood glucose levels. Amounts of insulin-bining antibodies vary greatly from person to person. More research is being done about how to control these antibodies.(3)
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  • Obesity:  It is a well-known fact that obesity reduces insulin sensitivity. Unfortunately, insulin is a hormone that stimulates the body to store fat, so people with diabetes who are on large amounts of insulin often find it very difficult to lose weight.

Potential Ways to Reduce Insulin Resistance in Type 1 Diabetes

Although insulin resistance can make it very difficult to control Type 1 diabetes, there are certain lifestyle habits that can greatly improve insulin sensitivity in people with Type 1 diabetes. Those habits include:

  • Reducing carbohydrate consumption and eating mostly low-glycemic carbohydrates:  Reducing the amount of insulin the body needs is a first step to helping cells “reset” and restore insulin sensitivity.
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  • Exercise:  As little as ten minutes of exercise improves insulin sensitivity for up to six hours. One study found that people who engaged in exercise and who followed a low-glycemic eating style had improved insulin sensitivity within just a week. Heavy weight lifting can improve insulin sensitivity for up to 48 hours. I engage in aerobic exercise and heavy weight lifting at least three times a week. If you are not currently exercising, start out slowly and increase your activity very gradually.
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  • Limited use of supplements:  There are some supplements known to improve insulin sensitivity. I am not mentioning then here because they should be used with caution and because each person’s personal physiology needs to be considered when selecting an appropriate supplement. There’s nothing healthy about taking handfuls of pills every day, so I am very cautious when recommending supplements and rarely recommend more then two. I’ve seen A1C levels drop in some clients by as much as 30% after the addition of a single supplement, even if the client refused to make dietary and lifestyle changes.
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  • Working closely with your physician or endocrinologist:  As lifestyle and dietary changes are made, it is imperative to work very closely with one’s physician and to monitor blood sugars very closely so insulin dosages can be adjusted as needed.
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  • Medication:  Although it’s not my first choice, some people with Type 1 diabetes and insulin resistance find that using medication such as Metformin helps them maintain normal glucose levels. Some also find a short trial of Metformin helps them lose enough weight that their physician can then very slowly wean them off of their Metformin dose.

There are no “easy fixes” for insulin resistance in Type 1 diabetes, but a combination of dietary and llfestyle changes can help. I know, because I’ve been able to reduce my insulin resistance and improve my health dramatically using a variety of small changes. After almost 50 years with Type 1 diabetes, I have no complications and live abundantly with ample energy. It is possible!

References:

(1) https://www.benaroyaresearch.org/what-is-bri/scientists-and-laboratories/scientific-staff/carla-greenbaum

(2) Diabetes Metabolic Research Review. 2002 May-Jun;18(3):192-200.

(3) Wien Klin Wochenschr. 1985 Apr 12;97(8):359-63

(4) The Interplay of Autoimmunity and Insulin Resistance in Type 1 Diabetes, Nokoff, Rewers, Cee Green; University of Colorado School of Medicine, 2/14/2012

The Most Commonly Ignored Cause of High Blood Pressure

The CDC estimates that 29% of adults (one in three) in the US have high blood pressure.1 Unfortunately, many people who Blood Pressure Titlehave high blood pressure are not aware of it. The National Institutes of Health defines high blood pressure as any pressure above 149/90, and prehypertension as any pressure above 120/80. It is common for doctors to put their patients on medications while they are in the prehypertension phase without encouraging any lifestyle changes, even though multiple studies proved lifestyle changes can be as effective as medication for lowering blood pressure.2

I want to be very clear that high blood pressure must be treated. Period. Allowing chronic blood pressure to remain elevated and untreated can lead to permanent physical damage and may result in death. The potential dangers of high blood pressure means it can be dangerous to refuse high blood pressure medication when a physician prescribes it. My encouragement is to use the medication while making lifestyle changes, and to then work with your physician to determine whether or not you can reduce the dose. Consider the medication a potentially temporary necessity. Reversing high blood pressure requires a commitment to making multiple lifestyle and eating style changes, but many people are able to work with their physician to reduce or sometimes eliminate their blood pressure medication after making the changes.

High blood pressure always has a cause. Mainstream medicine often addresses the symptom without taking time to determine its cause. My personal philosophy is that it is imperative to figure out WHY a symptom developed in order to correctly address it. Potential causes of high blood pressure vary, but may include (among other things) food allergies, excess alcohol consumption, obesity, systemic inflammation, hormonal imbalances, cardiac disease, high blood sugar, insufficient cellular oxygen, and many others. If diagnosed with high blood pressure, accept the prescription and then work with your physician to determine why your body raised blood pressure. High blood pressure doesn’t just happen. The body always has a specific reason for raising blood pressure. Take time to figure out the cause.

Sadly, medical literature rarely mentions the most common root cause of hyptertension:  Insulin Resistance. Insulin resistance occurs when the body’s cells stop absorbing insulin the way they should. This may occur due to chronic high blood sugars, excess consumption of sugars and high-glycemic carbohydrates, or other metabolic imbalances. When the body produces high amounts of insulin over a long period of time, the body’s cells can become “overwhelmed” by all the insulin and stop absorbing insulin in the quantities the body needs. Insulin is an inflammatory chemical, so the cell’s reduced absorption of insulin is a protective measure, but Insulin Resistance can have devastating results including elevated blood sugars, magnesium deficiency, vision problems, and more. For more information on the potentially negative effects of insulin, please read Surprising Facts About Insulin.

Insulin resistance may cause the following situations, each of which can cause high blood pressure:

  1. The cell’s refusal to absorb the insulin in the blood stream means the blood stream contains excess insulin. Insulin is extremely inflammatory, so the excess insulin in the blood stream may cause blood vessels to become inflamed. It is harder for the heart to pump blood through inflamed blood vessels, so this situation can quickly increase the pressure inside the vessels and may lead to measurable high blood pressure.
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  2. When insulin is not adequately utilized, the blood stream may also become filled with excess sugar. Sugar is highly acidic and causes inflammation. In the presence of high blood sugar, the body will elevate blood pressure to help it more efficiently attempt to lower the amount of sugar in the blood stream. Raising blood pressure also helps the body more efficiently carry oxygen to the tissues.
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  3. One of insulin’s primary functions is to carry magnesium into the cells. If the body reduces the amount of insulin it absorbs, the body’s cells therefore cannot absorb the amount of magnesium they require. magnesium’s most important job is to relax the blood vessels to maintain normal blood pressure. When a person is deficient in magnesium, it is likely the person will develop high blood pressure. People with Type 1 and Type 2 diabetes usually have insulin resistance and a magnesium deficiency. They therefore have a 90% chance of developing high blood pressure. Some doctors automatically prescribe blood pressure medication to their diabetic patients. These physicians assume there is no way to avoid high blood pressure in the presence of any form of diabetes. They are wrong. As someone who has had Type 1 diabetes for almost 50 years, I know high blood pressure can be avoided and/or reversed because I’ve done both.
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  4. Excess insulin can cause water retention. When water is retained in the tissues, it is more difficult for the heart to push blood through the vessels. The body therefore raises blood pressure to pump the blood more efficiently through tissues experiencing water retention..

Many people who have hypertension also have Insulin Resistance. I believe there is no such thing as “hereditary” high blood pressure. As the old adage states:  Genetics may load the gun, but lifestyle pulls the trigger. (Anonymous.)

So what lifestyle changes can potentially benefit insulin sensitivity and high blood pressure? Here are my top three starting recommendations:

  1. Exercise! Even ten minutes of exercise (three to five times weekly) is known to improve insulin sensitivity for four or more hours.
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  2. Eliminate most grains and sugars (including natural ones) for one to three months. Grains are metabolized into simple sugars that can make insulin resistance worse. Eliminating grains and sugars can help the body re-set its insulin sensitivity. This dietary change, combined with other lifestyle changes, can help the body lower blood pressure.
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  3. Discuss with your physician the possibility of taking daily magnesium and/or potassium. (Take a form of magnesium other than oxide, as it cannot be absorbed by the body and is worthless as anything except a laxative.) Magnesium and potassium are known to help relax the blood vessels and may help reduce blood pressure. For more information on the importance of magnesium, please read Why You Need More Magnesium.

The above steps are merely a starting point. There are other options that may help. If you have high blood pressure and wish to lower it using natural methods, please find a natural practitioner who can assist you. Until then, please keep taking your blood pressure medication and make sure your blood pressure stays within normal limits.

 

References:

1:  Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the US: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief, No. 133. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, US Dept of Health and Human Services, 2013.

2: http://www.unm.edu/~lkravitz/Article%20folder/hypertension.html

Top Ten Signs You Have Insulin Resistance

Insulin resistance is so common it now has multiple names. You may hear it called “metabolic syndrome,” “Syndrome X,” Lady with Insulin Resistance“pre-diabetes,” or “dysmetabolic syndrome.” MedicineNet.com says recent studies found 32% of the US population has insulin resistance. Sadly, this number includes many children.

Why is insulin resistance so common? Our modern lifestyle tends to combine a lack of exercise with a high carbohydrate eating style. This combination forces the body to release high amounts of insulin to counteract the blood sugar increases caused by the high intake of carbohydrates. Over time, the body’s cells become overwhelmed by the high levels of insulin in the bloodstream. They therefore stop absorbing and using the insulin. Insulin Resistance tends to be a precursor to Type 2 diabetes, heart disease, Polycystic Ovarian Syndrome and other negative health conditions. For more information on Insulin Resistance, please read Metabolic Syndrome: Modern Epidemic.

Signs of Insulin Resistance

The following signs may indicate you have insulin resistance:

  • Weight gain, especially around the stomach and waist:  Insulin signals the body to store fat, so increased levels of insulin caused by insulin resistance often creates an increase in body fat. The waist is the most common location of body fat caused by insulin resistance. People with insulin resistance often gain weight or find it impossible to lose weight even if they are eating less and exercising more. For more information on insulin, read Surprising Facts About Insulin
  • Fatigue:  Increased insulin levels and insulin resistance put a strain on the body that results in decreased energy levels. People who reverse insulin resistance often comment the increase in energy is their favorite part of restoring their health.
  • Feeling sleepy after eating a big meal:  Insulin resistance often results in slightly elevated glucose levels after a big meal loaded with carbohydrates. The body puts such a high priority on digestion it will divert energy from other body systems to help digest the meal. This, combined with the energy-draining effects of elevated blood sugars, often results in sleepiness.
  • High cholesterol and triglycerides:  The body creates triglycerides from the carbohydrates we eat, not from the fats we eat. When the body’s metabolism is negatively affected by insulin resistance, cholesterol and triglyceride levels will rise dramatically.
  • High blood pressure:  One of insulin’s lesser-known jobs is to control the pressure inside blood vessels. If the body stops absorbing insulin, an increase in blood pressure is a very common sign. I believe improving insulin resistance should be the primary course of action for most people with high blood pressure.
  • Brain fog and difficulty concentrating:  High insulin levels affect brain chemicals and neurotransmitter balance, which may negatively affect concentration.  
  • Depression:  Due partly to the physical changes caused by insulin resistance and partly by the effects insulin resistance has on brain chemistry and neurotransmitter balance.
  • Constant or increased hunger:  When insulin levels and/or blood sugars are elevated even slightly, the body stops turning food into energy. This results in a constant feeling of hunger as the body signals its need for fuel.
  • High blood insulin levels:  Did you notice I didn’t list high blood sugar? This is because people with insulin resistance often have normal fasting glucose levels, especially during the early stages of the condition. A fasting glucose level is not a realistic reflection of the body’s normal state, as most of us eat at least three times daily and very rarely fast more than 6-8 hours. The best way to detect insulin resistance is to measure the amount of insulin circulating in the blood stream. Although many labs claim insulin levels as high as 18 are “normal,” I start recommending subtle lifestyle changes as soon as insulin levels creep above 8.
  • Fatty liver disease:  If left unchecked, insulin resistance and elevated triglyceride levels cause fatty deposits to develop in the liver. These fatty deposits can result in fatty liver disease, liver damage that is unrelated to alcohol consumption.

Please note that each of these symptoms can be indicators of other health conditions. If you suspect you have insulin resistance, please consult with your health practitioner.

The good news is that insulin resistance can often be reversed using simple modifications to lifestyle and eating habits. There is hope! If you would like assistance creating healthier lifestyle habits, please feel free to contact me to schedule a consultation.

If you are ready to move forward and receive coaching to achieve your health goals, please join me for the E.N.E.R.G.Y. Life Revitalization Program! The program addresses insulin resistance and more. Click the link to learn more about this innovative 12-week program and receive a special discount.