By: Sheila Kun RN, BSN, MS, CPN, FCCP
Salesian Cooperator

For the past few weeks we have explored the basics of diabetes; what is diabetes, how the body metabolizes food, glucose and insulin production. We also discussed the risk factors of diabetes. This week, we will explore another concept in the management of diabetes: insulin resistance. I found a good article from Renewed Vitality. So sharing with you….

Insulin is a hormone that’s made by the pancreas. The pancreas is a large gland located behind the stomach and one of its functions is to produce insulin. This normally happens after we eat and blood sugar (glucose) levels spike. Glucose comes from the food that we eat. Insulin acts as a key for the glucose to enter the doors of the cells in muscles, the liver, fat, and other organs where it is used for energy. Once this happens, blood sugar levels in the blood are regulated back into a normal range.

The liver is also capable of making small amounts of insulin as needed, such as during periods between meals or when fasting.

Insulin Resistance is a condition that occurs over time. It happens when the cells in the body become “resistant” to insulin. As a result, glucose is unable to enter the cells effectively and blood sugar levels stay high in the bloodstream. The pancreas goes into overdrive and produces more and more insulin in order to move the glucose out of the bloodstream and into the cells where it’s needed.

When someone is Insulin Resistant, insulin levels rise in the bloodstream and can be up to 5 to 7 times higher than they should be. This has adverse effects on the metabolism, inhibiting the body’s ability to break down fats.

Insulin Resistance usually occurs in people who are obese, but it also occurs in people whose weight is in the normal range, depending on their diet and lifestyle. The common denominator is that fat accumulation is concentrated around the abdomen.

A Vicious Cycle

Insulin Resistance creates a vicious cycle and if not managed correctly, can quickly spiral into more serious problems. The cells that need glucose become starved of energy while glucose in the bloodstream stays elevated because there’s no place for it to go. Higher insulin levels signal the body to store fat, especially around the abdominal area. This fat (also called visceral fat) is especially dangerous because it causes the liver and other organs to become fatty and inflamed.

Visceral fat also causes Insulin Resistance, so it becomes a “chicken and the egg” situation since Insulin Resistance also causes this belly fat to accumulate.

Sheila’s note: I hope you capture these key points on Insulin Resistance:

• Glucose cannot go into the cells in the body to produce energy.
• Then Glucose in the blood stream remains high.
• The pancreas tries to produce more insulin sensing the high glucose level.
• Higher insulin levels signal the body to store fat.
• Fatty is stored in the liver, abdomen and other organs, causing fatty liver and subsequent inflammation.

Your homework from the Care Ministry this week: review the key points and see if it makes sense for you.

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