Insulin Resistance

Insulin resistance is a modern day problem that is the result of eating modern day foods. What insulin resistance means is that the cells in your body are resistant to insulin. While this may not sound like a big deal, it is. The more insulin resistant your cells become, the high your blood sugar rises (and your body hates high blood sugar). Let’s take a look at just how insulin resistance happens in your body.

How Insulin Resistance Forms

If your blood sugar shoots up high occasionally, there is really no problem. The problem comes when your blood sugar is high over a long period of time or high blood sugar happens every day. To understand this, you have to understand what is happening in the cells of your body.

The cells in your body only want so much sugar; they just want enough sugar to do their jobs. When there is constantly too much insulin and too much sugar in the blood stream (like when you eat sugar at every meal) the only response that the cells have is to remove the doorways (receptors) from the outside of the cell. This process is called down-regulation of receptors. When insulin receptors disappear throughout the body, it creates a whole-body effect called “insulin resistance,” meaning the cells of the body become “resistant” to insulin.

Let’s take a look at what happens to the cell when the body removes receptors, in the following diagram the yellow represents the cell and the blue thingies are the receptors.

A cell goes from having this many receptors (normal):

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To having, say, this many:

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Now, this is a bit tricky to understand, but imagine if all the cells in your body began to respond to too much sugar by removing their insulin receptors. If every cell in the body removed its receptors, the doorways to sugar, what would happen? The end result would be that you’d have more sugar in your blood.

Why?

Remember that insulin used to be able to push sugar out of the blood stream and put it into the cells. The cells, though, are now getting rid of receptors because there is too much sugar around most of the time. The cells are becoming resistant to insulin. So, even though there is sugar in the blood stream and a lot of insulin, the sugar has no where to go because the cells won’t allow it in. So, now, where does the sugar go? It stays in the blood stream.

But you also have to remember, more sugar in the blood stream creates what? The answer is more sugar in the blood stream leads to more insulin. When your body becomes insulin resistant, the next time you eat a meal, you have a higher amount of sugar in your blood because the cells are refusing to take on that sugar. So, more sugar in the blood stream means that the body will now release more insulin. Do you see the vicious cycle that is starting to develop? More insulin circulating in the body will eventually lead to fewer receptors on cells, which will lead to more sugar in the blood, and more insulin, and fewer receptors and…you get the idea.

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Cells will eventually look like this as they get rid of even more receptors:

Now you understand how insulin resistance can develop from eating a high amount of sugar every day. The association between eating sugars and the creation of insulin resistance is, however, far from being a proven phenomenon in human beings. Animal studies demonstrate a relationship between eating sugars and foods that act like sugar and the development of insulin resistance,[i],[ii] but the medical community is far from convinced. Like much of the scientific study on sugar and health, much more research is needed.

Over Time

Okay. Let’s see if we can pull this all together. Watch what happens over time, not to the individual cell, but in the whole body. The following chart shows how blood sugar and insulin react to each other and how insulin resistance builds over time when you are consuming sugar foods. (click on the image below to see full size).

What happens over time with insulin resistance is that the body can no longer produce enough insulin and, eventually, insulin production fails. When the body can no longer produce enough insulin or the cells have become resistant to insulin, your body is no longer able to keep blood sugar within a narrow range. This is called diabetes, a situation where the blood sugar is very high.

What Can You Do?

There is a lot that you can do to avoid insulin resistance, the chief among these is to stop eating sugar and foods that act like sugar. I have program called the 30 Sugar Free Days Program where you can join with other people who are giving sugar the boot.

Besides stopping the sugar feast, you can exercise, lower the amount of saturated fat in your diet and eat as many vegetables as you can. Insulin resistance is not a death sentence, but a wake-up call. There is a lot you can do to stop and reverse insulin resistance, but you have to get moving today.


[i] Bessesen DH. The role of carbohydrates in insulin resistance. J Nutr. 2001 Oct;131(10):2782S-2786S.

[ii] Daly M: Sugars, insulin sensitivity, and the postprandial state. Am J Clin Nutr. 2003 Oct;78(4):865S-872S.

6 comments

  1. Dr. Scott, I recently read a peer reviewed study indicating that cough syrups containing Dextromethorphan actually increase insulin production for those with Type 2 diabetes. If I’m already insulin resistant, am I wrong to think that more insulin will not solve the problem? When my body doesn’t use the insulin that it already has, what does the body do with the excess? I know your blood sugar increases, but what about all that insulin that’s still floating around? Why do the inject-able insulin’s work when my own insulin doesn’t?

    1. Hi Cynthia,

      This is actually a very difficult question. Insulin resistance occurs when there is too much sugar and too much insulin in the blood and the cells of the body down-regulate (remove) insulin receptors. So, you are right, more insulin will eventually lead to more insulin resistance and, eventually, diabetes. Insulin is a hormone, and like other hormones – does it job and then is recycled in the body.

      Over time, here is what happens: you have high blood sugar, this leads to high insulin. The cells of the body decide they have enough sugar, so they down-regulate insulin receptors. When cells become resistant to insulin, there is now more sugar in the blood, which leads to even higher insulin levels, which leads to more insulin resistance (it is an endless spiral). Eventually, though, your body will be unable to produce insulin and blood sugar skyrockets. You can overwhelm this system by taking injectable forms of insulin, but it will continue the problem.

      I wouldn’t worry too much about the cough syrup’s effect on insulin, but focus on eating low-glycemic foods and avoiding sugar and foods that act like sugar.

      Dr. Scott

  2. My husband is type 2 diabetes and has been taking insulin for about a year I am having to give him large doses of insulin as he just can’t seem to survive without his sweet tooth. I’m nervous about and don’t know where this is headed. Can you provide insight.

    1. Chris,

      It is hard for everyone to avoid eating sugars and the foods that act like sugars. As far as addictions go, it is one of the tougher to quit – in part because most people don’t see sugar as harmful and it is so readily available. Increasing insulin will only forestall the inevitable; there will be a time when it won’t work and blood sugar will rise. There is no doubt that long-term poor blood sugar control is harmful to every part of someone’s body, but especially heart, blood vessels, eyes, and kidneys. It is estimated that diabetics shorten their lives by as much as 12 years (when compared to non-diabetics); that puts diabetes on par with smoking for a shortened life. The good news is that making a dietary change can be hard, but people’s taste changes the longer they do it. You can check the comments for people going through the 30 Day Program and find that many people eat something sweet (cake, cookies…) after avoiding them for a while and cannot believe how sugary it tastes and how bad it makes them feel. There is hope.

      Best of luck,

      Dr. Scott

  3. Hi Scott,

    Do you think it’s a good idea to take Betaine Hydrochloride when you eat sushi? Or is it unnecessary? Thanks for your wonderful insight.

    1. Sheila,

      Hydrochloric acid breaks protein bonds (aid in digestion) and sushi is mostly protein. So, yes, it is a good idea.

      Hope you are well!

      Scott

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