Blood Sugar 101: Understanding Insulin Resistance
For decades the medical community and general population considered most blood sugar disorders an affliction of the elderly. With high carbohydrate diets and an increase in stress and obesity in our children, blood sugar dysfunction is becoming ever more common with a younger population. The distinct pattern of blood sugar dysfunction is described as insulin resistance. There are obviously some diseases that do not fall into this paradigm, such as Type I Diabetes or hypoglycemia that is due to organic disease or malignancy, yet most blood sugar dysfunction is associated with this model. The beginning of insulin resistance starts as functional or reactive hypoglycemia and the end stage is Type 2 Diabetes.
Hypoglycemia
After eating highly refined carbohydrates, the body responds with an increase in insulin production in an effort to lower blood sugar. Functional hypoglycemia is this drop in blood sugar, dipping below optimal levels due to the increase of insulin, the hormone responsible for transporting glucose into the cells. Seventy percent of the body’s blood glucose is utilized by the central nervous system. The symptoms of hypoglycemia therefore, are predominantly nervous system related such as behavior changes, poor mood, confusion, fatigue, palpitations, lack of concentration, sweating and hunger.
The body responds to the low blood sugar with the release of stress hormones, like cortisol and catecholamines, to increase blood sugar levels. Increase in stress hormones and sugar cravings are the outcome of a functional hypoglycemic state. Often times fasting blood glucose levels in lab tests will be normal in this phase.
Insulin Resistance
The constant roller coaster of high and low sugar levels with excess stress hormones causes the cells to become exhausted. Cells throughout the body, after constantly seeing insulin, begin to ignore it. Insulin becomes less effective at communicating with the cells in the body and more is needed to move sugar from the blood into the cells. High amounts of insulin circulate in the blood in order to communicate with these insulin resistant cells. The blood sugar regulation system begins to fail as the pancreas becomes taxed from the large amount of insulin it needs to produce. Insulin resistance also leads to high triglycerides in the blood, atherosclerosis and is also now being implicated in Polycystic Ovarian Syndrome and hormone sensitive breast cancers.
It is estimated that 25-35% of people in Westernized countries are in this phase of blood dysfunction. Insulin resistance has been shown to be one of the underlying causes of hypertension, high cholesterol, obesity, sleep apnea and cardiovascular disease.
Metabolic Syndrome
Insulin resistance is associated with a condition known as Metabolic Syndrome. Obesity or an increase in belly fat, high blood sugar, high blood pressure, low HDL cholesterol and high triglyceride levels all contribute to a diagnosis of Metabolic Syndrome. Metabolic Syndrome is a condition with a high risk for Type 2 Diabetes as well as cardiovascular disease. At this stage the patient may or may not look unhealthy. Though often belly fat or obesity are present, high blood pressure and abnormal lab tests can be silent symptoms.
Type 2 Diabetes
The end stage of blood sugar regulation failure is Type 2 Diabetes, where the body’s cells have become insulin resistant to the point where blood sugar levels, even after hours of not eating, remain elevated. Dietary modifications can still be made to avoid insulin dependence, a state where the pancreas has completely failed and insulin injections are required to lower blood sugar.
Prevention
The rapid increase in obesity, Type 2 Diabetes and hypoglycemia in children is a red flag for the need for lifestyle changes. Thirty percent of American children are reported to be overweight, many of them with insulin resistance or metabolic syndrome. Every stage of blood sugar dysfunction can be addressed with nutrition and lifestyle changes. The earlier these changes are made, the easier it is to reverse. Therapeutic lifestyle changes and improving blood sugar control can enhance not only stress response and reduce obesity, but also improve mood, concentration and energy. Investing in children’s nutrition will not only reduce their current health problems, but help avoid chronic disease in the future.
Dr. Lauren Young is a naturopathic physician with a family practice in Hartford Hospital Wellness Center in Avon, CT.