by Carl Marshall

Created on: May 31, 2011   Last Updated: June 02, 2011

Insulin resistance is where fat and muscle cells fail to uptake glucose in the presence of the hormone, insulin. This means that blood glucose levels will be too high and over the long term this can cause serious complications. If insulin resistance manifests itself in the form of diabetes, it may be difficult to increase insulin sensitivity, so that the cells absorb glucose. If a person has pre-diabetes, there is quite a lot which can be done to lower the risk of developing diabetes. Either way, there should be a conscious effort to improve insulin sensitivity.  Although the biolgical mechanisms are not well understood, there are lifestyle factors which influence insulin sensitivity.

Obesity

The Diabetes Prevention Program involved studying 3800 overweight prediabetics. The aim was to see if significant lifestyle adjustments could reduce the risk of diabetes.

The study was ended prematurely due to results of such statistical significance. The adjusted lifestyle group was shown to have a 58% reduction in risk of developing diabetes, without medication. From this it was concluded that weight loss was associated with improved insulin sensitivity and lower risk of type 2 diabetes.

Exercise

A study conducted by University of Maryland involved analysing the effects of aerobic exercise on glucose tolerance in prediabetic and normoglycemic people. Glucose and insulin levels were analysed before and after a 6 month period in response to oral glucose tolerance tests. It was concluded that those in the prediabetic group had more significant changes in glucose tolerance in response to aerobic exercise. Although the changes were not enought to reverse the prediabetes, clearly insulin sensitivity had improved.

Diet

Analysis performed by Harvard Public School of Health on the Men for the Health Professionals Follow up Study for different diets showed that  the Mediterranean diet and the DASH diet were significantly associated with reduced incidence of type 2 diabetes.

University of Navarra in Spain looked at 13380 graduates following a mediterranean diet. It was found that there was an 83% reduction in diabetes risk among those who followed the diet most closely compared to those who followed it least closely.

Lipid profile

Improvements in total cholesterol, HDL cholesterol and triglycerides seem to correspond with better insulin sensitivity. It is unclear whether a poor lipid profile directly causes insulin resistance or is merely a result of negative lifestyle factors which would also a poor glucose uptake.

Smoking

Of all the chemicals contained within cigarettes, nicotine is likely the main culprit in reducing insulin sensitivity. Nicotine causes fats to breakdown therefore increasing free fatty acids in the blood. As a consequence of the effects on the pancreas and liver, insulin sensitivity is adversely affected.

Conclusion

Clearly there is much which can be done to increase insulin sensitivity, particularly if someone hasn't yet developed type 2 diabetes. Everyone should try to achieve and maintain a healthy weight, take regular aerobic exercise, eat a healthy diet, avoid smoking and be mindful of their lipid numbers. It cannot be emphasised enough how important it is to be aware of the dangers of insulin resistance to health, it is a problem which is on the increase.

References:

http://www.diabetesvoice.org/files/attachments/artic le_334_en.pdf

http://diabetes.niddk.nih.gov/dm/pubs/preventionprog ram/

http://www.ncbi.nlm.nih.gov/pubmed/21464460

http://www.ncbi.nlm.nih.gov/pubmed/21606871?log$=act ivity

http://www.medicinenet.com/insulin_resistance/articl e.htm

http://en.wikipedia.org/wiki/Insulin_resistance

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