Nutrition for Insulin Resistance (Nutrition for Managing Blood Sugar)
/
Insulin’s primary role is to control your blood sugar.
I’ll get into more about insulin in a minute. But first, a quick orientation. This is the second in a series of posts where we dive into specific hormones and their connection with nutrition. (Check out the first article on thyroid hormones.) Why am I doing this series? Because “hormones” is one of the latest buzzwords in health on the internet. And, there’s both truth and manipulation intertwined in those messages. In this series, I’m teasing out the scientific evidence so you can spot the manipulation. Let’s start with a definition of hormones. What are hormones? Hormones are chemicals that your body creates to send a signal from one part of the body, through your bloodstream, to another part of your body.
Now, let’s get into the details about insulin.
We help a lot of people with managing blood sugar and insulin resistance. So, I wanted to cover it next in this series.
What Does Insulin Do?
Insulin is a hormone made in your pancreas. Your pancreas is a gland located near your stomach. As I shared already, insulin’s primary role is to control your blood sugar. When you digest carbohydrates (carbs), they’re broken down in your intestine into a sugar called glucose, which is absorbed into your bloodstream to be circulated to cells around your body such as your muscles and your liver. When glucose enters your blood, it signals your pancreas to release insulin. Insulin allows the glucose to move from your blood into the cells of your body where it’s needed for fuel. And, insulin helps your blood glucose to move into your liver where it’s stored to be used for energy later on.
Insulin Problems- What is Insulin Resistance?
There are two main types of problems with insulin.
Type 1 Diabetes (what used to be called juvenile or child-onset diabetes) is when the part of your pancreas that makes insulin has been damaged. This damage impairs your ability to produce insulin. That’s why people with type 1 diabetes need to take insulin (via needles or a pump). None of the dietitians currently on our team support people with type 1 diabetes so I won’t go further into this condition.
The second problem with insulin is more common: insulin resistance. In insulin resistance, your body’s cells aren’t responding to the insulin that you make and aren’t letting glucose into your cells. At first, your pancreas will release more and more insulin to get the results – i.e. move the sugar from your blood into your cells. It does this because your body is like Goldilocks – it wants just the right amount of sugar in your blood – not too much and not too little. When you have too much sugar in your blood, over a long period of time, it causes damage to your blood vessels. Those are the side effects of uncontrolled diabetes that you may be familiar with such as blindness, nerve damage (pain & tingling in feet and hands), and amputation. High blood sugar also is associated with inflammation. To prevent this damage, your body produces more and more insulin to get the job done of moving the glucose from your blood into your cells.
Over time, despite your pancreas producing extra insulin, the resistance is so great that your blood sugar remains high. It’s this stage when blood sugar levels are high despite your body producing insulin, that is called “pre-diabetes”. When blood sugar levels rise even higher, it’s called Type 2 Diabetes (what used to be called “adult-onset diabetes”).
Risks of Insulin Resistance
Several factors increase the risk of insulin resistance. For almost all of these factors, it’s not known how or why they increase the risk of insulin resistance.
Age: People over age 45 are at increased risk of insulin resistance.
Genetics: Insulin resistance has a genetic component. It runs in families. People of certain cultural/ ethnic backgrounds have higher rates of insulin resistance. However, it’s not certain how much is related to genetics and how much is related to the social determinants of health (or the interaction of the two as in epigenetics). Some cultural groups that experience higher rates of insulin resistance are Indigenous, Hispanic/Latinx, and Pacific Islander people.
Menopause: While the relationship is not fully understood, estrogen helps insulin do its work. When estrogen levels drop in the menopause transition, insulin resistance increases.
PCOS: It’s estimated that 75% of women with PCOS experience insulin resistance.
Sleep Apnea: Sleep apnea increases the risk of insulin resistance.
Larger Body Size: Insulin resistance rates are higher amongst people who carry more fat on their bodies. It’s not yet known whether the amount of fat causes insulin resistance or whether there is an unknown third factor that contributes to both the increased amount of fat and insulin resistance.
Physical Inactivity: Physical activity helps insulin do its job. Therefore, a sedentary lifestyle means that insulin must do all the heavy lifting by itself.
How to Support Insulin with Nutrition (Nutrition for Blood Sugar Control)
Move Your Body: Going for a walk or doing other forms of physical activity after you’ve eaten helps insulin clear blood sugar.
Choose Less Refined Carbs: When carbs are more refined, they take a shorter time to digest, resulting in the glucose hitting your bloodstream faster, i.e. a blood sugar spike. Choose whole grains so that they are digested more slowly. It’s easier for your body to handle the slower arrival of glucose into your bloodstream.
No Naked Carbs: Eat foods containing protein and/or fat when you have foods that contain carbs. I.e., don’t eat carbs alone (a.k.a. naked). Protein and fat help to slow the release of sugar into your blood – a similar result as #2 above.
Eat Fewer Carbs: It’s logical that if you eat fewer carbohydrates, you will have less glucose entering your blood. Your body will be less stimulated to release insulin. Ketogenic (“keto”) diets are very, very low carb. But you can also eat lower or low-ish carb too. It doesn’t have to be a choice of high carb or keto. Those are just the two ends of the spectrum. Many factors go into deciding what level of carbs is a fit for you, including your physical activity, what foods you enjoy, how frequently you eat socially, and who else is in your household. What’s important is choosing a way to eat that fits your life long-term. Two weeks of doing keto isn’t going to fix your insulin resistance.
Have Good Vitamin D Status: A meta-analysis found that having good vitamin D levels in your body reduces insulin resistance. To achieve a healthy vitamin D status, most of us will require vitamin D supplementation. I don’t have a specific amount to recommend because we customize our supplement recommendations to each individual.
Consider Other Supplements: There are supplements that have intriguing, although not definitive, scientific evidence regarding their impact on lowering blood sugar. Examples include berberine, chromium, and magnesium. As I shared above, I don’t give supplement recommendations in blog posts. We always individualize supplement recommendations because we take into consideration: what you eat, health diagnoses, medications, and other factors.
Want more information on managing your hormones? Check out this article on Nutrition for Thyroid (Supporting Metabolism).
Photo by Alexander Grey on Unsplash
References
Centers for Disease Control and Prevention: Insulin Resistance and Diabetes
Moghetti, P., Tosi, F. Insulin resistance and PCOS: chicken or egg?. J Endocrinol Invest 44, 233–244 (2021). https://doi.org/10.1007/s40618-020-01351-0
Gabryelska Agata, Karuga Filip Franciszek, Szmyd Bartosz, Białasiewicz Piotr. HIF-1α as a Mediator of Insulin Resistance, T2DM, and Its Complications: Potential Links With Obstructive Sleep Apnea. Frontiers in Physiology.11. 2020. DOI 10.3389/fphys.2020.01035
Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes: A Systematic Review and Meta-analysis of Individual Participant Data From 3 Randomized Clinical Trials https://doi.org/10.7326/M22-3018
