What is insulin?
Insulin is a hormone made by the pancreas. It plays a significant role in
regulating blood sugar levels. It also has a major function in
determining how much energy we store as fat or burn at the cellular level. When
we eat food that is high in carbohydrates, they are digested and broken down to
glucose. This leads to increase in blood glucose. The pancreas senses this increase
and secretes insulin.

The insulin then helps to lower blood sugar to normal levels. It acts through
insulin receptors located on the cell membranes. The insulin receptors are the
gateway through which glucose enters the cell. Once inside the cell, the glucose
can be used for energy or stored as fat. The presence of insulin favors the storage
of energy as fat through a process called lipogenesis. It also suppresses the
lipolysis which is the breakdown of fat.

What is insulin resistance?

Insulin resistance develops when the cells become less responsive to insulin.
As a result, we need more insulin to lower the blood glucose level. The pancreas
responds by making more and more insulin. Ultimately this leads to persistently
high levels of insulin. This condition is known as hyperinsulinemia. To make
matters worse, the cells become even less responsive in the presence of
hyperinsulinemia. This can lead to a rise in blood sugar causing prediabetes
and eventually diabetes.

Apart from glucose, other potential causes of insulin resistance include fructose,
inflammation, lack of activity and even gut bacteria.
Insulin resistance is common. Estimates are that almost a third of Americans
have it and do not know. This is because insulin
resistance has no specific symptoms. Some people with insulin resistance may
have darkening of the skin on the back of the neck or in the arm pits. This is
referred to as acanthosis nigricans. You can also check for insulin resistance by
measuring blood insulin levels and a test called HOMA-IR. Other telltale signs
from blood test include high triglyceride levels and low HDL (good cholesterol)

How to treat insulin resistance.
Steps that can help treat insulin resistance include:
·Healthy diet. A high protein and lower carbohydrate diet is a good example. Get
about 40% of daily calories from high quality protein sources, 30% from
carbohydrates and 30% from fats. Keep carbohydrate intake to between 50
grams and 150 grams a day and mostly from complex carbohydrates. Limit added
sugar to less than 40 grams a day. Stay away from processed carbohydrates such
as cookies, candies, cakes, pastries, to mention a few. Get at least 5 servings of
vegetables and two servings of fruit a day.
·Exercise. Get at least 30 minutes of moderate paced exercise a day for at least 5
days a week. Add resistance training on at least 2 nonconsecutive days.
·Medications. Some medications used to treat diabetes can also improve insulin

Dr. Ife Ojugbeli, MD, MBA