Today I'm talking to you about insulin resistance. It is one of the cornerstones of our practice as weight loss doctors in helping people lose weight, reverse metabolic disease, and really preventing future health problems along the way.
And sometimes as doctors we forget that not everyone knows what insulin resistance is. I guess what I want to do today is actually explain what does it mean?
Insulin is a hormone made in our pancreas. It's there to move glucose (which we also refer to as sugar) from our blood into our muscles so that we can then use that glucose for fuel. Now, the thing is that for some people, and genetics plays a part here, our body requires more and more insulin to do that job.
The word resistance I think, could be called tolerance. We're insulin tolerant, which means that our muscles become tolerant to the effects of insulin, so our pancreas has to make more and more insulin to do the same job. Now, the thing is, this can be going on for years and you have no idea. I call, it's “what's going on under the hood”. Under the hood in our body, our pancreas is just doing its job. The pancreas' job is to basically produce insulin because we want to keep our blood sugar between four and six.
Blood glucose is allowed to go up when we've eaten but then it needs to come back down, because prolonged high glucose in our blood is toxic to our cells, so that's why the problems happen with diabetes. We get damage to our eyes, to our kidneys, to our feet, to our nerves, really affecting almost every system within our body. Diabetes is a whole body disease. So our body, our beautiful pancreas is trying to prevent our body from getting diabetes.
Now there's a few side effects from having too much insulin in your blood, okay?
Insulins' other job is that it's a fat storing hormone. It does this by stopping fat breakdown.
So if you have high circulating insulin for the majority of your day, you cannot access stored fat. So it's like your reserves, your reservoir is blocked, and this is where we call it the woodshed. Your woodshed is locked and you cannot access you stored fat for fuel. Listen to our podcast episode explaining the woodshed analogy here.
The other things that insulin does, is that it is a growth hormone. So some of the signs that you might have insulin resistance, things that grow.
So skin tags. So when you see people, I mean, as doctors, we see skin tags all the time and we just freeze them, but what we really need to be doing is asking why? Now one skin tag, no big deal. But if people have a lot of skin tags on their neck, under their arms, under their boobs, if they're a girl, even in your groin, that's insulin resistance.
The other thing that can sometimes present and it a little more unusual and a sign of much more severe insulin resistance is pigmentation, hyperpigmentation.
So pigmentation just means darkening of the skin. So you can get darkening of the skin in your armpits, around your neck. Some people have seen it on their forehead, so it's a darkening of the skin.
Then the third sign that might give us a clue is really your waist circumference. So if your fat stores are all around your belly, then you are likely to have insulin resistance.
So then you think, "Well, what's the big deal? Apart from the fact that I store some fat." Well, again, being a growth hormone, it is part of the reason why we have high blood pressure, because the walls of our arteries grow thicker than they would otherwise. It's part of the reason it increases the risk of cancer. Cancer is just rapidly turning over growing cells, insulin facilitates that. These are all the reasons why as doctors, Mary and I, and a lot of doctors particularly in the low carb world are obsessed with insulin.
We want it to be as low as possible because it is a major hallmark for chronic disease. So when we talk about insulin resistance, imagine insulin tolerance. It's a little bit like when you have alcohol and if you drink heavily, your body becomes quite tolerant to the effects. When you remove the alcohol, your body becomes more sensitive to the effects. You go drinking a slab a day with little effect to then being a one pot screamer-meaning one glass will have a big effect.
So it's the same with insulin. We can reverse this resistance merely by reducing the carbohydrates therefore reducing the work the pancreas has to do. When you reduce the work the pancreas has to do, it doesn't need to make as much insulin that gives your tissues a chance to become sensitive again. We call it insulin sensitivity.
So I am insulin resistant. Dr Mary is insulin resistant. It's part of my family history. I have a strong family history of type two diabetes. My dad has type two diabetes, my aunt, a couple of cousins. It's on one side of the family.
I didn't know I was insulin resistant.
This was how I used to eat. I would take a bag of untoasted muesli to have for lunch at the start of the week. I would take a bag of frozen mango and I would take a big tub of yoghurt and I would have this for lunch. And it would be a huge bowl because I was starving. And everybody would be telling me how virtuous I was for eating this beautiful, healthy, lunch.
But I was tired, hungry and gaining kilos.
It was not helping me at all. I was insulin resistant, all that was doing, that giant load of carbohydrate unprocessed and all as it was, was still going straight into my woodshed, worsening my insulin resistance. Had I continued down this path I would have ended up with type two diabetes. Instead, I lead a low carb lifestyle, I've reversed my insulin resistance. My path to diabetes is no longer. I've changed my future health path. And that is what we want for everybody. We want you thriving in a beautiful, healthy lifestyle. And honestly, for insulin resistance, it really does come down to that simple fact that we need to reduce our carbohydrate.
Dr Lucy Burns