Insulin Resistance

We all have heard about insulin, right? if we have heard about diabetes probably yes, we have, but if you haven’t then keep reading.

What is insulin anyway?

Insulin is a hormone in our bodies. Its primary purpose is to help our body cells to use up sugar to provide us with energy. Without insulin, sugar cannot be utilized by body cells.

Source of Insulin

Insulin is produced by the pancreas in the beta cells. The Pancreas is located just below your stomach and near the small intestines.

Not only for sugar

Insulin does not only facilitate the uptake of sugar in the body cells. It also regulates how the body uses up fats and the proteins that we eat.

Insulin promotes the formation and storage of fat in the body.

Release

The release of insulin from the beta cells follows a rise and a fall pattern. It starts with a rapid initial phase followed by a less intense but sustained phase. When sugar is ingested, the brain commands the beta cells to release insulin in its stores. It is usually stored in pockets in the cells of the pancreas, called granules.

It’s like a granary waiting for sugar to be eaten and it releases insulin from its stores. In the first phase, insulin is released within 1 minute and reaches a maximum level within 3 to 5 minutes.

The second phase of insulin release is brought about by the action of hormones that are produced from the Gut. This phase lasts the period of high sugar levels in blood. Meaning that more insulin will be produced as long as sugar in blood is high.

Half of the insulin produced in 24 hours is produced even without any sugar intake, that is,fasting. The maximum release of insulin from the pancreas is induced by 20 grams of sugar when given through the veins in 3 minutes.

What determines the rate of Insulin production?

When you take sugar the rate of insulin production will depend on these factors;

• The sugar load; This is the amount of sugar in the food that you have taken, more sugar will cause more insulin production.
• Gastric emptying; This is the opening of the stomach to let its contents enter the first part of your small intestines, if the stomach empties slowly there will be less insulin produced.
• Gastrointestinal motility; The movement of your intestines affects the absorption of sugar into your blood. High motility leads to a higher rate of sugar absorption and thus more insulin production.
• Gastrointestinal hormones; If some hormones are not appropriately produced when food is in the GUT, it may cause less insulin to be produced.
• Brain activity; It is the brain that controls all the hormones that are produced in the body, the right signals and pathways are needed to produce the right amount of insulin in the body.

So, what is insulin resistance?

We shall go back to history first, of a researcher known as Sir Himsworth in the 1930s. This physician noted that diabetic patients when injected with insulin and sugar concurrently resulted in 2 things.

Some patients got a decrease in the amount of sugar in their blood, and these are what he called insulin-sensitive patients.

Others got an increase in the amount of sugar in their blood, and these were termed as insulin insensitive or insulin resistance.

How is happens

Insulin resistance happens when the target tissue cells that normally use up sugar from blood like the muscles, liver brain and spleen cells lose the ability to reduce sugar from blood despite insulin being available.

In this state the body fails to;

• stop the production of sugar from the liver
• control the breakdown of fats into sugar
• uptake sugar from blood,
• form stored sugar in the liver in form of glucagon.

What causes insulin resistance?

Insulin resistance occurs mainly at the muscle cells and liver cells. These cells are the major sites that remove sugar from blood. In these cells, sugar is absorbed and stored as glucagon or used to produce energy directly.

These cells have what we call receptors which I liken to Gates, which if well opened allow sugar to enter the cells. The key to opening these gates is the insulin.

The problem in insulin resistance is that there are reduced number of these gates on the target cells, but also the ability to open them is decreased even when the key, that is, insulin is attached to them. It is as if the gates have rusted bolts and hinges.

It is common in people who are overweight, obese, have hypertension and Type 2 Diabetes.

What causes the decrease in the number of gates or the gates not working is not yet clear. But it seems to be greatly associated with not being physically active and having a lot of body fat.

Too much insulin production

When the body fails to use up sugar in blood properly, the beta cells think that they are not producing enough. So more insulin is secreted as the body tries to compensate. This results in increase in the amount of insulin in blood even during fasting.

Increased amounts of insulin in blood worsen the insulin resistance. While insulin resistance leads to increased amount of insulin in blood. It becomes a viscous cycle; it is difficult to know for sure which one started before the other.

How it gets worse

When insulin resistance has started and you continue to pump the body with sugar and you are not physically active the cycle worsens. This state results in failure of the beta cells to produce insulin because of exhaustion. Too much sugar circulating in blood becomes toxic to the beta cells leading to their death.

The results of insulin resistance

Insulin resistance results into the increase in the amount of circulating fats in blood, these fats are also toxic to the beta cells. Death of the beta cells worsens the Type 2 Diabetes disease.

For a person to have high blood sugar which is the hallmark of diabetes disease, there must be two things;

One is a fault in the action of insulin in the target tissue cells, and the other is a problem in insulin production in the pancreas.

The good news

The good news is that these faults can be reversed in Type 2 Diabetes disease. This can be done by losing weight, restricting the amount of sugar intake from carbohydrate foods as you become more active.

At dimpediabeteshealth.com we care to bring you diabetes health coaching and knowledge.

wishing you utmost good health-Afya bora zaidi