- The important role insulin plays inside the female body.
- What causes insulin resistance and why it has such a big impact on women’s health.
- Signs and symptoms of insulin resistance including weight gain, cravings, fatigue, skin tags, and more.
- Testing for insulin resistance, including measuring waist to hip ratios and key markers in blood testing.
- How insulin resistance impacts our hormone balance and specifically PCOS.
- The main causes of insulin resistance, including diet and lifestyle factors like stress and sleep.
- Treatment and tips for how to prevent or reverse insulin resistance.
The importance of insulin
When we eat and digest food, glucose enters our blood to provide energy for our cells. Insulin is the hormone that allows glucose to enter the cells and provide energy; it ‘unlocks’ our glucose transporters.
Our blood glucose needs to be tightly controlled because if it goes too high or too low, it can be dangerous and cause damage to the body. Therefore, the body needs to deal with this as a priority.
What is insulin resistance?
Insulin resistance (or hyperinsulinemia) is the condition of having chronically elevated levels of insulin. It occurs when our cells do not respond well to the insulin signal and the body needs to produce more insulin for it to have the same effect.
Insulin resistance can have a huge impact on women’s health and can lead to PCOS, acne, heavy periods, and fertility problems. It also causes weight gain, specifically abdominal weight gain, and is a risk factor for diabetes, cancer, osteoporosis, dementia, and heart disease.
Signs and symptoms of insulin resistance
The main sign of insulin resistance is weight gain around the waist. High insulin levels actually block stored fat from being broken down and used for energy.
Insulin resistance specifically causes apple-shaped obesity, so the larger your waist circumference, the more likely you are to have insulin resistance. Your waist should be less than half your height.
Measuring waist to height ratio
This simple measurement compares your waist to height ratio.
Measure the smallest point on your waist (cm)
Divide that by your height (cm)
= your waist to height ratio
A ratio of more than 0.5 is linked to an increased risk of developing health problems.
However, you don’t need to be overweight to have insulin resistance!
Other signs and symptoms of insulin resistance
Besides weight gain, other signs and symptoms include:
- Sugar cravings
- Skin tags
- Acanthosis nigricans – a dark velvety discolouration of the skin in the armpits, groin, and folds of the neck
- High triglycerides
- Fatty liver
Can you test for insulin resistance?
You can test insulin and fasting insulin via an insulin response test, which will need to be done by your doctor.
However, there are other markers you can test to give you insight into your metabolic health. Our nutrient blood panel at FUTURE WOMAN includes two important markers for insulin resistance:
- Haemoglobin A1c (HBA1C) measures blood glucose averages over the preceding three months. It’s based on glycation, the process by which glucose molecules attach to hemoglobin in red blood cells.
- Triglycerides-to-HDL ratio. Triglycerides are a type of lipid stored in fat cells when there’s excess glucose in the body. Elevated levels can indicate poor control of blood sugar (usually a result of too much sugar or refined carbs in the diet). The TG/HDL ratio is the best way to test for insulin resistance other than the insulin response test. The ratio should be around 2-2.5:1 but the optimal is 1:1
Insulin resistance and menopause
Perimenopause and menopause can increase the risk of insulin resistance because of our changing hormone levels (oestrogen is a key metabolic hormone and increases insulin sensitivity). It’s really important to consider during this time because insulin resistance can worsen any symptoms of perimenopause and menopause. Also, we can naturally become testosterone dominant when we lose oestrogen and progesterone, and this can worsen insulin resistance.
What causes insulin resistance?
A range of diet and lifestyle factors:
- Sugar: glucose leads to imbalanced blood sugar, which leads to insulin resistance, and too much fructose can lead to oxidative stress, inflammation, and fatty liver – which can all contribute to insulin resistance.
- Too many carbohydrates/starch can also lead to blood sugar imbalance (the amount of carbohydrate someone can tolerate can vary hugely from person to person).
- Inflammation, which can impair insulin sensitivity (too much fructose can lead to inflammation).
- Poor sleep/disrupted circadian rhythm.
- Stress (whether psychological, physical, internal or external).
- Environmental toxins can block insulin receptors.
- The oral contraceptive pill.
- A sedentary lifestyle or inactivity (coupled with too many carbs or too much sugar in the diet).
What can we do to prevent or reverse insulin resistance?
The good news is, there is much we can do to prevent and even reverse insulin resistance.
Here are some key ways to prevent or reverse insulin resistance.
- Remove most, if not all, sugar from your diet. This includes ‘healthier’ sugars like honey and dates and hidden sugars, for example in sweetened yogurts. Stick to whole fruits.
- Eat a blood-sugar-balancing diet. For example, make sure you have a balance of protein, fat, fibre, and complex carbs for each meal
- Maintain a healthy circadian rhythm and sleep. Our circadian rhythm (body clock) has a profound effect on glucose metabolism and insulin sensitivity, and a disrupted circadian rhythm is a contributing cause of insulin resistance. The best way to support your circadian rhythm is natural light exposure in the morning as well as protein for breakfast and low lighting in the evening. Maintaining a healthy circadian rhythm can also promote better sleep – and when we don’t sleep well, our blood glucose management can be much poorer the next day.
- Regular exercise is one of the best ways to increase insulin sensitivity. It helps move sugar into the muscles for storage and promotes an immediate increase in insulin sensitivity.