Insulin Resistance Evolves to Type 2 Diabetes and Other Costly Disease

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Insulin resistance has been brought to our attention with more and more studies, reports, Ted Talks, articles by doctors, and even an article I wrote, titled "Biggest Health Problem in the U.S.," yet there are no significant programming or dieting changes recommended by the government health and medical community. There are, however, a few in the medical and nutrition field who have been waving the red flag for years as our country is now sporting 70 percent overweight or obese numbers.

Now, even our military is representing those numbers as more and more of the active duty members are overweight or obese. With a national type 2 diabetes and pre-diabetes rate of 37 percent, it is only a matter of time before our national crisis affects the pool of military candidates on a strategic level. In fact, Type 2 Diabetes has doubled in the last 10 years and quadrupled since 1980! Currently, the number one reason why young men and women cannot join the military is they fail to meet the height / weight and body fat percentage minimum standards. So our nation’s health and wellness has already started to affect recruiting numbers.

Insulin Resistance is Pre-Pre-Diabetes, and a precursor to other illnesses such as Heart Attack, Alzheimer’s Dementia, Cancer, Kidney Disease, Stroke, Gout, Obesity, and of course, Type 2 Diabetes. Recent studies are linking insulin resistance to Type 2 diabetes and Alzheimer’s to a degree that Alzheimer’s is being considered Type 3 Diabetes, says Dr. Georgia Ede.

Insulin Resistant vs Insulin Sensitive

We are rapidly becoming a nation of insulin resistant bodies – unable to metabolize sugar properly. Since more than half of the American population are Insulin Resistant, you should know more about this dangerous precursor to disease. The difference between insulin resistance and insulin sensitivity is the same as saying unhealthy and healthy with regards to blood sugar and other common health numbers. You want to be sensitive to the effects of insulin, so that it can do its job and help you metabolize carbohydrates. Insulin resistance is a hormonal condition that basically makes our body unable to process carbohydrates, thus elevating blood sugar levels, creating inflammation, and interfering with fat and cholesterol metabolism. However, you do not have to be overweight to be insulin resistant.

Who Is To Blame?

To blame our overweight and excessive carb status on the government guidelines is not overreaching, with current information about Big Sugar driving studies and health information toward fat being the biggest culprit to our health for over 50 years. The current nutrition guidelines require a moderate number of daily calories, but as a nation we eat almost DOUBLE (3,770 cals/day) our daily caloric recommended rate of 2,000 calories a day. And most of these recommended calories come from carbohydrates. Sure, if we as a nation would eat less and move more, there would be different obesity numbers following these guidelines. But, once you are in the insulin resistant / pre-diabetes category, your diet has to change from the current guidelines. You should start thinking and eating like a diabetic. That means eliminating sugar. Limit other carbohydrates as well. These include grains, potatoes, and anything processed. Can you limit your daily carbohydrates to 50grams a day? Try and see how you feel and monitor the results.

At some point, we can only blame this health crisis on our own habits of consuming too much sugar or over-eating.

The proponents of changing the current nutrition guidelines and dropping the massive recommendation of carbohydrates from our diet are gaining acceptance, as new research is making strides toward low carbohydrate (ketogenic) lifestyles. Currently, the Defense Advanced Research Projects Agency, the Department of Defense, and NASA are researching not just the lower carb methodology as a meal planning option, but also a treatment for illnesses associated with a higher carbohydrate / sugar diets. The future of the space program may rely on such dietary changes and research.

How Do You Know if You Have Insulin Resistance?

There is an easy method of determining the Insulin Resistance Ratio (IRR) -- simply take your most recent blood scores, or Triglycerides divided by HDLs = Insulin Resistance Ratio (TG/HDL = IRR). Dr. Greenwald said this is a basic method to see if further testing needs to be done as any ratio score of more than 2.5 (women) and 3.0 (men) means you are insulin resistant.

Insulin Resistance (IR) is defined by Dr. Greenwald as: “When humans become insulin resistant, the glucose receptors of our liver and muscle cells get clogged. Glucose stays in the blood stream and blood glucose levels increase and so does the blood insulin levels as the pancreas keeps pumping more and more insulin to try to keep blood sugar (glucose) levels under control.”

The more accurate measure is to take a Nuclear Magnetic Resonance (NMR) spectroscopy of your blood. Basically, this MRI of your blood measures the numbers of different particles that carry cholesterol and triglyceride. Dr. William Cromwell of LabCorp states:Quantitative changes in lipoproteins are one of the earliest indicators of insulin resistance. The TG/HDL-C ratio has been proposed as a simple indicator of insulin resistance in overweight and obese patients. NMR spectroscopy provides a more detailed and refined assessment of the lipoprotein abnormalities that identify IR at an early stage of development regardless of weight, glucose or insulin measurements.”

“Not only is NMR LipoProfile LP-IR a more sensitive and specific marker of IR than TG/HDL ratio, it continues to significantly predict incident (new onset) development of diabetes after adjustment for multiple confounders (including adjustment for age, sex, race/ ethnicity, BMI, family history of diabetes, alcohol use, smoking, physical activity, use of lipid lowering medications, hormone therapy, HOMA-IR, TG/HDL-C ratio, as well as concentrations of glucose, insulin, HDL-C, and TG). When simultaneously adjusted for glucose and HOMA-IR, or glucose and the TG-to-HDL-C ratio, the NMR LP-IR score remains significantly predictive of incident diabetes.”

If you are curious, do the math on your own IR Ratio, then ask your doctor to take your blood and send it out for the test using these methods. If you can get a 10-15 year head start on diabetes, would you takes steps to prevent it?

For more details of a typical Health Screening and treatment for such ailments see the Health Screening 101 Series.

Note: I would like to give a special thanks to Dr. Greenwald of Specialty Health and his team of professionals in medicine and nutrition for his assistance with this article.

References of Dr. Cromwell comments:

McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Annals of Internal Medicine. 2003;139:802-809
Garvey WT, Kwon S, Zheng D, Shaughnessy S, Wallace P, Hutto A, Pugh K, Jenkins AJ, Klein RL, Liao Y. Effects of insulin resistance and type 2 diabetes on lipoprotein subclass particle size and concentration determined by nuclear magnetic resonance. Diabetes. 2003;52:453-462
Goff DC, Jr., D'Agostino RB, Jr., Haffner SM, Otvos JD. Insulin resistance and adiposity influence lipoprotein size and subclass concentrations. Results from the insulin resistance atherosclerosis study. Metabolism. 2005;54:264-270
Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, Greenland P, Lackland DT, Levy D, O’Donnell CJ, Robinson JG, Schwartz JS, Shero ST, Smith SC, Sorlie P, Stone NJ, Wilson PWF. 2013 acc/aha guideline on the assessment of cardiovascular risk: A report of the american college of cardiology/american heart association task force on practice guidelines. Circulation. 2014;129:S49-S73
Festa A, Williams K, Hanley AJ, Otvos JD, Goff DC, Wagenknecht LE, Haffner SM. Nuclear magnetic resonance lipoprotein abnormalities in prediabetic subjects in the insulin resistance atherosclerosis study. Circulation. 2005;111:3465-3472
Mackey RH, Mora S, Bertoni AG, Wassel CL, Carnethon MR, Sibley CT, Goff DC, Jr. Lipoprotein particles and incident type 2 diabetes in the multi-ethnic study of atherosclerosis. Diabetes care. 2015;38:628-636

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