How to Live with Insulin Resistance

Unfortunately, insulin resistance is quite common during menopause.

Due to the hormonal changes classical of menopause, there is an increased vulnerability to developing insulin dysfunction and its associated symptoms during this time.

Insulin resistance is usually associated with abdominal weight gain, and both insulin resistance and abdominal weight gain are strong risk factors for developing Type 2 Diabetes.

What Is Insulin and What Is Insulin Resistance?

Insulin is a hormone. Its job is to make sure that glucose moves from the blood stream into each individual cell, ensuring glucose (energy) is available for cellular use. When someone has insulin resistance the cells in the body are less responsive to insulin. This results in the cells not receiving the glucose or the energy that they require. This can lead to a buildup of glucose in your blood that is commonly referred to as high blood sugar.

If insulin is not being recognised, or being less recognised, it is not effectively doing its job. As a result, the pancreas starts to increase production of insulin to try and be more effective, further contributing to a high blood insulin level. This often remains undetected and can contribute to a diagnosis of Type 2 diabetes or latent autoimmune diabetes of adults.

Symptoms of insulin resistance can be low energy, weight gain (particularly around the abdomen), sweet cravings and difficulty concentrating.

Insulin resistance is often a lifestyle condition, and as such, when recognised early, it is manageable. Some professionals consider insulin resistance a reversible diagnosis. It is believed that a combination of poor diet, poor exercise and/or poor hormone response may be the cause for insulin dysfunction. It is for this reason that we at the Australian Menopause Centre heavily assess hormones, diet and lifestyle.

“I Have Insulin Resistance, Now What?”

Diet is absolute key to maintaining an optimal insulin response. If a suitable dietary change is not maintained long term, you remain vulnerable to redeveloping, or worsening your insulin response, and thus your type 2 diabetes risk.

Exercise: How important is exercise?

Exercise is almost as important as diet. Exercise has an amazing capability of directly influencing your insulin sensitivity. Studies have shown that individuals who are physically active are less likely to develop insulin resistance.[1]^,[2] Further to this, studies also showed that exercise provided a protective effect for those at a high risk of developing insulin resistance¹. The great news is that it doesn’t have to be flogging yourself with high-intensity exercise – moderate intensity exercise is enough to improve your insulin sensitivity².

Diet: What Should My Long-Term Diet Look Like?

For the long term, familiarising yourself with the glycaemic index and glycaemic load is a handy way to manage long term blood glucose levels.

The glycaemic index is a way of ranking carbohydrate containing foods according to their effect on blood glucose.

Foods are given a number from 0-100 according to how fast their carbohydrate is converted to glucose and enters the bloodstream. The lower the number, the slower the rise in glucose. The lower the number, the gentler the effect on insulin. Foods with a GI of 55 or less are called low GI foods. Moderate GI foods are 56-69 and high GI of 70 or above. Simply put, eating foods that are low GI has a positive impact on blood glucose levels of individuals.

Examples of low GI foods include:

Food	GI value	Food	GI value
All-bran	30	Green peas (frozen)	39
Oat bran	50	Raw carrots	16
Rolled oats	51	Boiled carrots	41
Soya and linseed bread	36	Eggplant	15
Wholegrain pumpernickel	46	Broccoli	10
Heavy mixed grain bread	45	Cauliflower	15
Whole wheat bread	49	Cabbage	10
Egg fettuccini	32	Mushrooms	10
Brown rice	50	Tomatoes	15
Buckwheat	51	Green beans	15
Pearled barley	22	Onions	10
Spaghetti	32	Cherries	22
Walnuts	15	Plums	24
Cashews	25	Apples	34
Kidney beans	52	Pears	41
Butter beans	36	Grapes	43
Chickpeas	42	Oranges	40
Red lentils	21	Strawberries	40
Pinto beans	45	Whole milk	31
Soy milk	44	Skim milk	32

* http://www.the-gi-diet.org/lowgifoods/

Clinical studies have shown that low GI carbohydrates improve glycaemic control and cholesterol profiles in Type 2 Diabetes[3].

According to Shyam S et al, it is evident that women with a history of gestational diabetes showed significant improvements in body weight and glucose response when a lower GI diet was consumed[4]. Further to this, Brynes et al have shown that the opposite (a high GI diet) appeared to increase insulin resistance after a measly 24 days of poor dieting[5]. This particular study highlighted not only the speed of insulin resistance developing, but it highlights the immediate importance of dietary choices. After only 24 days of poor eating, your health could be taking a dive.

If you are confused about the glycaemic index, or not up to learning the glycaemic load of certain foods, don’t worry. More evidence has shown that subjects with impaired glucose control can EITHER reduce their glycaemic load OR reduce their total carbohydrates. Both diets over a period of four months reduced blood glucose levels equally[6].

Just by reducing your carbohydrates you can make a big difference.

What is a carbohydrate? The term ‘carbohydrate’ refers to a group compounds found in an array of foods that break down into glucose (sugar) before being absorbed into the bloodstream for energy. A refined carbohydrate is one that has been processed before it is consumed. Some examples of refined carbohydrates are bread, pasta, pastry, biscuits, crackers, rice etc.

What About Right Now? Can I Speed Up the Process?

Sure!

There are two main ways you can speed up the process of improving insulin resistance. If you are overweight losing weight through diet and exercise can significantly speed up the process of improving insulin response. Alternatively, you can improve the picture by introducing a supplement aimed specially at improving insulin response and sweets cravings.

Need to Lose Weight?

There are many diets in the spotlight at the moment. Depending on how much you want to lose, and how fast you want to get the weight shifting will depict which diet may be more suitable. Request an appointment with one of our naturopaths or nutritionists to discuss your individual picture.

The two foundational diets recommended are the ketosis style of eating known as ‘Shake-it’, and a low fat ‘Shake-it’ diet. Both of these options are not only great at aiding insulin response, but they are designed to get weight moving.

Once you have reached your goal weight, we strongly recommend a maintenance diet of either a low GI diet, a low refined carbohydrate diet or an individualised alternative.

Once again, if you want to discuss this in more detail, please request a consultation with one of our qualified naturopaths or nutritionists – if you are a patient of the Australian Menopause Centre most of the AMC programs include access to the team as part of your member benefits.

Get Started!

If your fasting insulin levels are above 10, there is a good chance you need to make some changes!

Why wait? Start now!

 

FAQs

Interpreting your blood results:

The fasting insulin pathology shows how much insulin is in your blood in a fasting state. This indicates how much insulin is floating around in your blood in a state of calm or reserve. Once you eat some food, the glucose in that food stimulates your insulin levels to increase to an appropriate amount. Ideally, fasting insulin should be less than 10.

Do I have type 2 diabetes if I have insulin resistance?

No. But many people refer to insulin resistance as being ‘pre-diabetic’. If you continue your current eating and exercising lifestyle there is a good chance you may develop type 2 diabetes.

Am I likely to get type 2 diabetes?

Insulin resistance is often referred to as a ‘pre-diabetic state’. Insulin resistance can be viewed as a warning and can be used as motivation to start making changes. Whilst insulin resistance is not diabetes, it can lead to diabetes.

Some tips to try in any household!

Eat more vege – in general, eat as many vegetables as you want! Just keep an eye on your potato (this is not an encouragement to eat hot chips 3x day!). Boost up your meals with a variety of vegetables, increasing your fibre, nutrients, and making you feel full.

Cut the sugar – if you are adding sugar to your tea or coffee, or have a lolly or biscuit in the afternoon, cut it down or cut it out. Significantly reduce, or remove, any obvious sugars – table sugar, chocolate, lollies, cakes, biscuits, honey. Talk to us if you feel like you may need some support or ideas to make this happen.

Substitute – !

• Change white bread or pasta to whole grain bread and pasta.
• Change dessert to a piece of fruit.
• Change soft drink for soda water with fresh lemon or lime.
• Change chocolate to 80% cocoa dark chocolate.
• Change flavoured yoghurt to natural Greek yoghurt, then add some fresh fruit if you want.
• Change your oils to olive oil or coconut oil.
• Change rice to quinoa (and cook it the same way).
• Change potato chips to popcorn.
• Change sports drinks to coconut water.
• Change juice to water (or half water half juice).
• Just to name a few.

 

 

References:

[1] Ivy JL. Role of exercise training in the prevention and treatment of insulin resistance and non-insulin-dependent diabetes mellitus. Sports medicine (Auckland, NZ). 1997;24(5):321-36.

[2] O’Donovan G, Kearney EM, Nevill AM, Woolf-May K, Bird SR. The effects of 24 weeks of moderate- or high-intensity exercise on insulin resistance. European journal of applied physiology. 2005;95(5-6):522-8.

[3] Ludwig DS, 2002, The glycaemic index: Physiological mechanisms relating to obesity, diabetes and cardiovascular disease, Journal of the American medical Assosiation,287, 2414-2423

[4] Shyam S et al, 2013, Low glycaemic index diets improve glucose tolerance and body weight in women with previous history of gestational diabetes: a six months randomised trial, Bio med Central.

[5] Brynes AE et al, 2003, A Randomised four-intervention crossover study investigating the effect of carbohydrates on daytime profiles of insulin, glucose, non-esterified fatty acids and triacylglycerols in middle-aged men, British Journal of Nutrition, 89, 207-218

[6] Wolever TMS & Mehling C,2003, Long-term effect of varying the source or amount of dietary carbohydrate on post prandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance, Am J Clin Nutri, 77:612-21