Insulin resistance doesn’t happen overnight. When most of your diet includes empty calories and an abundance of quickly absorbed sugars, liquid calories, and carbohydrates like bread, pasta, rice, and potatoes, your cells slowly become resistant to the effects of insulin.
Your body increasingly demands more insulin to do the same job of keeping your blood sugar even. Eventually your cells become resistant to insulin’s call, resulting in insulin resistance.
The higher your insulin levels are, the worse your insulin resistance. Your body starts to age and deteriorate. In fact, insulin resistance is the single most important phenomenon that leads to rapid, premature aging and all its resultant diseases, including heart disease, stroke, dementia, and cancer.
Insulin resistance and the resulting metabolic syndrome often comes accompanied by increasing central obesity, fatigue after meals, sugar cravings, high triglycerides, low HDL, high blood pressure, problems with blood clotting, as well as increased inflammation.
Even without these warning signs, one test can determine high insulin levels years or even decades before diabetes develops. Early detection can help you reverse these symptoms, yet doctors rarely use this crucial test that can detect high insulin levels.
Why Doctors Miss the Initial Warning Sign of Insulin Resistance
Doctors have been trained to measure a person’s fasting blood sugar, or the glucose levels present in your blood, at least eight hours after your last meal. Most don’t express concern until results show blood sugar levels reaching 110 mg/dl. That’s when they start “watching it.” Then, once your blood sugar reaches 126 mg/dl, your doctor will diagnose you with diabetes and put you on medication.
The important thing to note is that blood sugar is the last thing to increase…so for many people, a fasting glucose test detects diabetes too late. Long before your blood sugar rises, your insulin spikes. High insulin levels are the first sign that can precede type 2 diabetes by decades, Damage begins with even slight changes in insulin and blood sugar.
A two-hour glucose tolerance test can help detect high insulin levels. This test measures not only glucose but also insulin levels, yet doctors rarely order it. Instead, they usually don’t express concern until blood sugar is over 110 or worse, over 126, which is diabetes.
Many of my patients have normal blood sugar levels but very high insulin levels and other signs of pre-diabetes, yet when they come to see me they have not been diagnosed with pre-diabetes.
Even when they have a blood sugar level over 100 mg/dl and a two-hour glucose tolerance test result of over 140 mg/dl, 90 percent of patients who display these conditions have not been diagnosed. That’s because doctors don’t measure insulin.
Think about this. Insulin resistance contributes to most chronic disease in America, a country with world-renowned health care, yet 90 percent of people who have this condition have not been diagnosed. One test could change all that.
I recommend early testing for everyone:
- Over age 50
- With a family history of type 2 diabetes
- With central abdominal weight gain or abnormal cholesterol
- With any risk of insulin resistance (even children)
Ask your doctor for a 2-Hour Insulin Glucose Challenge Test. This should be done when fasting, with blood sugar and insulin levels checked at fasting, then again at one- and two-hour intervals.
Your blood sugar levels should be less than 80 mg/dl fasting and never rise above 110 or 120 mg/dl after one and two hour checks. Your insulin should be less than 5 mg/dl fasting and should never rise above 30 mg/dl after one and two hour checks.
If your results show high insulin, you need to eliminate the things that are sending your biology out of balance and include what’s needed to help your body rebalance itself. These eight interventions can become extraordinarily powerful to normalize insulin:
- Eat whole, fresh foods. Food is information that controls your gene expression, hormones, and metabolism. Choose low-glycemic real foods including fresh vegetables, fruits, legumes, non-gluten grains, nuts, seeds, and high-quality animal protein.
- Remove all sweeteners. Far from the free pass some people consider them, artificial sweeteners can raise insulin levels and contribute to insulin resistance. One study in the journal Diabetes Carefound sucralose (Splenda) could raise glucose and insulin levels. Give up sugar but also stevia, aspartame, sucralose, sugar alcohols like xylitol and malitol, and all of the other heavily used and marketed sweeteners unless you want to slow down your metabolism, gain weight, and increase insulin resistance. Many of us have lost touch with what constitutes “sweet,” and we have to retrain our taste buds to appreciate the natural sweetness of, say, natural vanilla or roasted almonds.
- Control inflammation. Dietary sugars of all kinds and refined vegetable oilsare the biggest contributors to inflammation. They increase insulin levels and turn on genes that lead to chronic inflammation, creating a downward spiral into more inflammation, poor blood sugar control, and chronic disease. Besides removing the offending foods, address food sensitivities and allergies to control inflammation. Incorporate plenty of anti-inflammatory foods including wild-caught fish, freshly ground flax seed, and fish oil.
- Increase fiber-rich foods. Whereas our Paleolithic ancestors got 50 – 100 grams of fiber a day, we now average less than 15 grams. Studies show high-fiber foods can be as effective as diabetes medications to lower blood sugar without the side effects. Fiber slows sugar absorption into the bloodstream from the gut. Eat a wide variety of fiber-rich plant-based foods including nuts, seeds, fruits, vegetables, and legumes.
- Get enough sleep. A study in The Journal of Clinical Endocrinology and Metabolism found in healthy subjects, even a partial night of poor sleep contributes to insulin resistance. Make sleep a top priority to normalize insulin levels. Avoid eating three hours before bed and take an UltraBath to raise your body temperature and relax your muscles. Go to bed and wake up at consistent times, only use your bed for sleep and sex, and try herbal therapies or melatonin if necessary.
- Address nutrient deficiencies. A number of nutrients play a role in insulin management, including vitamin D, chromium, magnesium, and alpha lipoic acid. Deficiencies in any nutrient can stall your biochemical machinery, knocking your blood sugar levels out of balance and making you more insulin resistant.
- Incorporate the right exercise. Exercise might be the most powerful medicine to manage blood sugar levels and make your cells more insulin sensitive. When it comes to exercise, time becomes a huge hurdle for many people. That’s why I recommend high-intensity interval training (HIIT), also called burst training, which you can do in just minutes a day. A study in the Journal of Obesity found among its other benefits,burst training helped decrease fasting insulin and reduce insulin resistance. Combining burst training with weight resistance provides the most effective, efficient way to normalize blood sugar and insulin levels.
- Control stress levels. Chronic stress elevates cortisol, your main stress hormone. Increased cortisol levels elevate blood sugar and promote the accumulation of belly fat that I commonly see in patients with insulin resistance or diabetes. You can’t eliminate stress, but you can reduce its impact. Find what works for you. That might be meditation, yoga, deep breathing, or exercise.
If this seems like a lot, don’t worry. I’ve created a 10-Day Detox Diet Challenge that will help you address, step-by-step, each of these areas. This Challenge includes live coaching support from my nutrition team and me, community support and a complete toolkit. To learn more or to register, click here.
What other strategies would you add to control blood sugar, normalize insulin levels, and reduce your risk for obesity and chronic illness? I welcome you to share your thoughts here or on my Facebook fan page.
Wishing you health and happiness,
Mark Hyman, MD