Insulin is a hormone produced by the pancreas that moves glucose from the bloodstream into the cells so it can be used to fuel the function of the cells and tissues of the body. In people with Type 1 diabetes, the pancreas is unable to make sufficient insulin to drive glucose into the tissues and thus they require injectable insulin to make up the difference.

Insulin resistance is when insulin is being produced by the pancreas, but it is not as effective in moving glucose into the cells and tissues. This results in higher blood glucose levels and an increased amount of glucose that is stored as fat particularly in our mid-section, which is called “truncal obesity”. Insulin resistance plays a role in the “metabolic syndrome”, which is a constellation of obesity, high blood pressure, high cholesterol and Type 2 Diabetes.

What Causes Insulin Resistance?

Risk factors for developing insulin resistance include:

  • Obesity
  • Inactive lifestyle
  • Diet high in processed carbohydrates
  • Smoking
  • Medical conditions such as non-alcoholic fatty liver and polycystic ovarian syndrome
  • Genetics/Family history
  • Medications such as steroids

How We Combat Insulin Resistance

  • Address the potential causes above with your doctor, fitness/nutrition coach.
  • Minimized processed carbohydrates (ie avoid “added suger” in the things we eat).
  • Reduce carbohydrate consumption to 30-40% of caloric intake (speak to your nutritionist).
  • Exercise! Skeletal muscles have a special metabolic pathway that is independent of insulin which helps to move glucose into muscle tissue (Glut4 pathway).
  • Pharmacotherapy – In more severe cases, there are a variety of prescription “insulin sensitizers” that can help with insulin resistance and Type 2 diabetes as an adjunct to the lifestyle modifications above. As always, check with your physician! ■

Carla DiGirolamo is Board Certified in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility specializing in the care of women through all stages of life. She was named among the Top Doctors in the Boston area by Boston Magazine in 2019 and 2020. She is also a Crossfit Level 1 Trainer and member of Crossfit Physicians, Les Mills BodyCombat/BodyPump Instructor and Certified Precision Nutrition Level 1 Coach.