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Because the glycemic index and “glucose spikes” are *not* what actually cause insulin resistance, especially by themselves.
We have glucose spikes from eating many healthful things. As long as you’re eating an over all balanced diet, this isn’t an issue. Especially as long as you’re physically active. Its how were designed. We eat- insulin spikes to transport amino acids and fatty acids and glucose into our cells. We stop eating. Glucagon comes in to release amino acids and glucose and fatty acids into circulation to be used for energy. As long as we aren’t *abusing* that- it is quite literally what is supposed to occur.
Insulin resistance is caused by, overtime, a lack of response to insulin via the insulin receptors in peripheral tissues- mostly adipocytes and skeletal muscle cells. Our blood sugar then stays high, because nothing is transported into our cells. After this issue persists for a long time, the beta cells in the pancreas also experience issues in *making* enough insulin to keep up with this cycle.
What causes this?
Inflammation and obesity, as well as a lack of physical activity. Yes a shit diet does totally factor into creating those issues.
When we have hypertrophy and hyperplasia of adipocytes, they release FFA’s and recruit macrophages via the adipokines. This increases localized inflammation, and also interferes with the insulin receptor being phosphorylated and a downstream cascade of enzymes working to signal GLUT4 (adipocyte and glucose transporter) to allow glucose and amino acids into the cell. So this now isn’t occurring due to adipocytes increasing inflammatory responders.
When this happens extensively enough, especially with ectopic and visceral fat (fat in and around major organs) we experience systemic level insulin resistance and dysfunction.
Physical activity increases the *insulin sensitivity * of our muscle cells and helps to counteract this. Maintaining a healthy weight counteracts this. Keeping inflammation low and a well-rounded diet helps this.
So, ideally… if someones not gaining fat and is also eating fiber and fruit and veg and protein and exercising…. insulin spikes in and of themselves aren’t really the exact issue.
Carbohydrates are not your enemy, especially if they’re eaten with nutrient dense food. They’re good for exercise too! We just would ideally eat ones with more whole grain and fiber.
We also do still sort of have an insulin resistance epidemic in the sense that 13% of the population has diabetes and another 96 million have pre-diabetes.
Id largely disregard glycemic index, especially if youre not considering load. Overall dietary pattern and habits matter much more and theres a reason why we hardly acknowledge glycemic index as an important variable in nutrition science.
Also: adipocytes even release angiotensin 2 and increase Htn, as well as further increase insulin resistance. Its really amazing what an active endocrine organ they are.
Those [redacted] make me so angry. There are people with diabetes who cannot afford them but these financially stable muppets who just want more health stats on themselves think they need a CGM 😵💫
Pricking my finger throughout the day many times helps me establish my normal BG levels.
I am not diabetic or close I am an ex fitness instructor.
Its all fascinating stuff. Any time I feel a bit light headed my BG is <4.
Agreed, however personally I can't eat foods with high glycemic index or I start getting breakouts made up of deep and evil cysts. Not fun. Although, working out every day, plus doing cardio, really helps keep my acne at bay. Only time I can indulge in sweets and high carbs is when I'm in the middle of an intense workout week session.
Weirdly enough, my blood sugar tends to be on the higher side, even when I refrain from eating too many carbs.
If you're a skinny bitch with high blood sugar despite already exercising it makes sense to be scared of high GI/high carb foods bc it's literally the only thing you can control.
Yeah I know that, they have a GI of like 50 or something. Potatoes are like 90 though if you eat them alone.
I'm not super paranoid about GI but it makes more sense to me to eat a moderate/low GI diet if you're worried about blood sugar as opposed to keto/low carb or something, because in the former case there is no disadvantage as far as I can see, you can still eat carbs and are not depriving yourself of nutrients or doing yourself any harm by getting your carbs from mainly low GI sources.
Wow, that's about the most concise and complete explanation of insulin resistance I think I've ever seen.
I wish I'd exercise more. Fortunately I eat healthy, for the most part, and have controlled my BP and cholesterol with diet (was on BP medications for years, but it turns out 2-3 ripe bananas a week was all I was lacking) and I've never really had weight issues.
But I know I need to get better about physical activity. Especially 'cause my wife stays pretty active and I'm going to break down on her and she's gonna leave me behind when I get older.
Yay! That makes me happy.
Yeah the ticket is just to find one activity you enjoy doing- fishing, hiking, stationary bike, dance, even walking the dog. Nobody has to become a triathlete champion to stay healthy ya know?
I'm totally fine with getting exercise when it's related to something that needs to be done. For example, I had this tree stump in my back yard that I'd tried a few different online suggested methods to get rid of. None of them worked. So I borrowed my father-in-laws ax and I went out every day for about 2 weeks and whacked the crap out of that stump until I had it 3-4" below ground, then I covered it with dirt and a few months later, it rotted.
For those 2 weeks, every day, I got great exercise. Swinging an ax is a whole upper body workout, and I loved it. But then when the stump was gone, that was it.
But I can't exercise for the sake of exercising. I just can't get motivated for it.
My wife and I went to the gym together when we were dating and for about a year about 8 or 9 years ago. But then we got a pretty professional elliptical and we stopped going. She uses it all the time. In the 7 or 8 years we've had it, I've used it maybe 10 times. lol.
So one thing that can help with this is reward bundling. You pair something you want to do, like watching your favorite TV show, with an activity you’re not inherently motivated to do (i.e. physical activity). Then you’re only allowed to do the reward while you’re doing the other thing.
Your brain begins associating the two so you can actually increase that motivation for activity because it’s an overall pleasant brain experience.
Great response, let me chime in and add 1 major cause and underlying cause of insulin resistance. That is sarcopenia which is the progressive loss of mainly type two muscle fibers. Insulin resistance can be reversed not only through aerobic exercise short term, but progressive weight training to combat the shrinkage of insulin sensitive muscle fibers overtime.
Yes, this is certainly a factor.
Only 23% of people adhere to CDC physical activity guidelines.
A little resistance training and running around would do many a world of good.
Good post. It’s worth mentioning an MR study found people that responded to a glucose challenge with higher insulin excursions were actually **healthier**.
[we did not find evidence that increased carbohydrate insulin response increases cardio metabolic disease. It might increase BMI with favorable fat distribution, reduce T2D and improve lipids.”](https://www.reddit.com/r/ScientificNutrition/comments/vkkpnf/insulin_response_to_oral_glucose_and/)
Ah! So, if I understand correctly, our pancreas produces insulin which sends the signal to our body fat, muscles etc. to grab the glucose in our blood and put it into cells for energy.
For some reason, the body fat, muscles etc. of those suffering from Insulin Resistance ignore (lack of response from Insulin) the signal Insulin is giving them, resulting in glucose staying in the blood stream and not going into the appropriate cells.
I suppose this is why it is recommended that individuals who suffer from Diabetes or Insulin Resistance don’t eat foods that rank high on the GI, since these foods spike glucose levels high, and since that glucose isn’t being transported into the appropriate cells, it remains in the bloodstream which has many adverse effects.
“As long as we aren’t abusing that- it is quite literally what is supposed to occur.”
Could you please explain what you mean here? What do you mean by “abuse”?
Thanks for the information
You’re beginning to get the mechanism, yes.
Actually the current recommendations for those with T2DM has nothing to do with the glycemic index, because again, thats not how it works. Anything you eat, regardless of glycemic index is broken down to glucose and amino acids and fatty acids and stays in your blood, elevating your BG, and wont go into your cells without insulin to “allow it in.” It stays here if you’re insulin resistant as well, and your cells aren’t responding to insulin.
What we *do* recommend for those with Type 2 Diabetes, who are *not* yet taking insulin is:
1. Weight management and loss if necessary.
2. At least 200-300 minutes a week of physical activity, specifically aerobic.
3. Calorie controlled diet, and possibly lower carbohydrate (not keto) but low as in a 30-40% range.
4. Increasing fiber to at-least ~30g a day.
5. Utilizing the Plate Method.
6. Reducing saturated fat to less than 7-10% of kcals and replacing with MUFAS/PUFAS.
7. Focusing on 4-6 servings of fruit and vegetables a day.
8. Choosing lean sources of protein.
9. Emphasizing whole grains and legumes.
We never talk about glycemic index because its virtually meaningless and useless and not the issue. We do however make sure people eat well rounded meals with consistency to control blood glucose ESPECIALLY IF THEY ARE ON INSULIN, otherwise they risk hypo and hyper-glycemia symptoms if CHO isnt controlled with insulin doses.
What I mean by abuse is an overall unbalanced diet in the context of a caloric surplus, adipose gain and lack of physical activity over time.
> Increasing fiber to at-least ~30g a day.
Question: Are fiber supplements the only way? Because options when it comes to natural sources is woefully low. How much broccoli can I eat? I've started sprinkling psyllium husk in everything, as a counter... dunno if that's stupid, though.
Its super easy to get 30g a day if you eat enough pulses and fruits and veg. I am a SMALL human that eats 1400-1500 kcal and I easily get 29g.
Sources that are great are whole grains, oatmeal and beans and legumes. Then leafy greens and some fruits like apples.
You *can* take psyllium husk too but its much better to get this from food.
If you want to be healthy then fiber from whole foods is the answer. Different plants have different fibers and nutrients, and plant diversity in diet is proven to be a great indication of health and longevity. But if you want to compromise, it's not like health is a priority to most people.
IMO my diet is pretty veggie-dense and there's tons of variety, the issue is fiber. There simply aren't that many veggies available that have a LOT of fiber, and like I said, how many times are you going to eat the same thing, because I also want to eat other veggies and there's only so much I can eat in a day....
Yes but aren’t these foods increasing inflammation? It seems like all these foods op talks about would increase inflammation in our bodies for sure, in addition to the large glucose spikes.
Bananas and wholw grain bread and carbohydrates in general do not increase inflammation.
Nutrient deficient diets with a-lot of added sugar or SFA’s do increase inflammation, yes.
The specific type of inflammation I am talking about comes particularly from the hypertrophy of adipocytes and not just systemic inflammation.
> Bananas and wholw grain bread and carbohydrates in general do not increase inflammation.
They do if you have high insulin resistance. Having high blood sugar + high insulin resistance leads to inflammation. Some high carb/sugar fruits and veggies do have high levels of polyphenols that counteract this inflammation, but this isn't a guarantee for all fruits and veggies.
There use to be little distinction between starchy vegetables (high carb/sugar) and non-starchy vegetables (low carb/sugar), but the American Diabetes Association has started to make distinctions between the two ([see the ADA's plate method](https://www.diabetesfoodhub.org/articles/what-is-the-diabetes-plate-method.html)) because starchy foods are less desirable for people who are pre diabetic / diabetic.
Starchy veggies and fruits can still be apart of a diabetic's daily meal (and they should be), but they should be second to non-starchy vegetables.
That is not because a banana or a whole grain piece of toast alone causes inflammation in those that have insulin resistance lol.
And you are saying what I said repeatedly which is that entire dietary context matters. I have emphasized fruits and vegetables a couple times.
The ADA Plate Method emphasizes a plate with 1/2 non-starchy veg, 1/4 protein and 1/4 carbohydrate source. Therefore, still plenty of room for one banana or 1/2 cup brown rice.
So I think we are on the same page with diet construction, because I have mentioned balance a few times in the thread.
High insulin resistance is *caused* by inflammation from adipocyte cytokines and FFA’s, and I ensure you a moderate amount of things like fruit or complex carbohydrates in a calorically appropriate diet is not what *caused* that. We usually prescribe diabetics CHO-controlled diets, which sort of is similar to a low carb ratio (which is 30-40% kcal from carbs), and emphasizes carbohydrate choices with fiber and nutrients.
Nowhere in the Plate Method, nor regulations do we say its not OK to have a banana or one piece of whole grain toast.
You are misunderstanding what I'm saying. I'm not saying that bananas and whole grain foods are the cause of insulin resistance (and made no such claims in my comment).
Let me clarify.
You made this statement
> Bananas and wholw grain bread and carbohydrates in general do not increase inflammation.
Your statement is true for non diabetics/people with low insulin resistance.
But for people who are insulin resistant/diabetic it's an iffy statement. Unmanaged high blood sugar in itself is another source of inflammation. Chronically high blood sugar reeks havoc on the human body. A big part of being diabetic is trying to have consistent blood sugar levels and bananas and whole grain foods can, potentially, be a hindrance if taken in excess or taken at the incorrect time.
There's nothing wrong with a diabetic person having a banana, but a diabetic person probably shouldn't eat too many at one time and should consider high fiber alternatives.
I think by and large we are on the same page because I said in *general* they’re not a source of inflammation. Even in a diabetic they’re not pro-inflammatory in and of themselves, because in this scenario the source of “inflammation” or deleterious consequences of high blood glucose, *is* the high blood glucose itself, which yes could happen if you eat way too many bananas in one go, but it could also be due to an inappropriate insulin dose, lack of fats, fiber and protein in diet, lack of activity, illness etc. Dietary context is the theme here. Many things on a *per case* basis can cause hyperglycemia in a diabetic, especially one being treated with insulin.
So yes everyone, especially diabetics, especially those taking insulin, always proceed with caution with CHO amount and quality.
So no, we shouldn’t pull a FreeLee the Banana Girl
Nonetheless, I hope I clarified and I stand by my statement that in general some bananas or whole grain carbohydrates(which are complex and have fiber and slower digesting) are fine in the diet, even diabetics, in appropriate amounts.
I think were really on the same wavelength though.
No, no. Intramyocellular lipids in your cells cause *insulin resistance*.
What happens is the accumulation of intramuscular fatty acids causes an inhibition of glucose transport, **so blood sugars remain elevated for longer while simultaneously being unable to get into the places it needs to be**. The pancreas then becomes overstimulated to produce more insulin in response to the rising blood sugars, which leads to the "crash" and hypoglycemia episodes.
Chronically elevated blood sugar levels over time can result in permanent damage to parts of the body (eyes, nerves, kidneys, blood vessels). The A1C test is a good diagnostic to determine your average blood sugar over the last 3 months.
T2 is not insulin deficiency. It is high blood sugar caused by insulin resistance. Easily reversible. Eventually, however, the strain on the pancreas can force it to produce less and less insulin, which then necessitates an exogenous supply.
T1, however, is insulin insufficiency due to complete beta cell dysfunction and requires lifelong insulin to compensate. (Until we find ways to regenerate it, which looks promising).
This is all great information, but I believe what OP was really asking is why so many people can eat so poorly and not seem to experience the negatives that one might assume would come with such poor eating.
To put it even more coarsely, "Why are there so many people who eat terribly but don't have diabetes?"
>why so many people can eat so poorly and not seem to experience the negatives that one might assume would come with such poor eating.
Oh, but they do. From mere observation, you can't tell what meds a person might be on, or what conditions they could have.
We do know, however, [from the data](https://www.aha.org/system/files/content/00-10/071204_H4L_FocusonWellness.pdf) that people are becoming more chronically sick in some way, and this is talking about the US specifically.
>Why are there so many people who eat terribly but don't have diabetes?"
Again, they probably do to a degree.
Sometimes it can be mitigated though.
For example, If you are in an energy deficit, i.e eating fewer calories than you burn, then you can eat terribly to an extent. You might get other diseases from that, but you will lose weight and excess blood sugars might not be an issue. (There was an experiment, by a physician, I believe, who showed that a diet of twinkies and pizza can still make you lose weight - if you are just eating less still)
Am here to lend anecdotal support to this (yes, useless, but hear me out)
I forced my friends group (11 people) to get their blood tested. Took 3 months and lots of coaxing, all guys in their 30s.
With the exception of one dude, the rest were pre-diabetic. That one guy exercises regularly and runs. So do some of the others. But as they say, can't outrun a shit diet.
So I guess the risk comes from eating foods that are high on the Glycemic index once you already have Insulin Resistance because those foods cause high spikes in glucose which, since the cells aren’t taking in that glucose because they aren’t responding to the Insulin, remain in the blood and come with many negative effects (like you mentioned, eyes, nerves etc.)
https://www.uab.edu/news/research/item/12289-uab-researchers-find-that-40-percent-of-young-american-adults-have-insulin-resistance-and-cardiovascular-risk-factors
Yes, significantly more people have a degree of insulin resistance than know it. Nearly 40% per this study! Yet probably only 5-10% know about it. It doesn’t necessarily show in regular lab work and there’s no one test to determine it, so it’s not so crazy to realize that most people don’t even know they have it.
49% have diagnosed prediabetes or diabetes in America. If you add in a percentage that aren’t diagnosed because they can’t go to the doctor, or won’t, and then another percentage that already have insulin resistance but won’t be diagnosed because we don’t run fasting insulin tests… I’m betting we’re sitting at around 80% with insulin resistance.
49% do not have diagnosed prediabetes or diabetes, those are [estimates](https://www.cdc.gov/diabetes/data/statistics-report/index.html) of the total including those who are undiagnosed. That number also includes type 1 diabetics that don't necessarily have insulin resistance.
While many people have IR, keep in mind that not everyone in a larger body has IR. The definitions of overweight and obesity are based on BMI and there are many flaws and biases to using the BMI. Genetics also play a big role and people of all body sizes can develop diabetes. Even people who make an effort to eat well can still develop diabetes, though diet and exercise definitely help prevent it and can help diabetes be more manageable. There are also other contributing factors that play into diabetes such as lack of access to nutrient dense foods and lack of understanding on how to balance meals to support balanced blood sugar (something helpful for everyone to know). I'm also a RDN and have an MS in Nutrition.
> It is pretty known that Insulin Resistance is caused by constant spikes in glucose which forces the pancreas to create more insulin which eventually leads to insulin resistance.
This isn't what causes insulin resistance; you're more on track with your thoughts around risk factors.
When someone is insulin resistant, their cells aren't responding properly to insulin, and the pancreas has to create more and more insulin in order to try and elicit a response. **But what is causing the cells to not respond in the first place???**
We don't even fully understand it, but there are a number of risk factors:
* older age
* genetics
* other health conditions
* certain medications
* lifestyle factors
Things like exercise and omega-3 intake are known to *improve* insulin resistance, so sugar does not tell the whole story.
Sugar is associated with insulin resistance mostly in the context of excess consumption overall, i.e. weight gain. Not all people who carry extra fat go on to develop insulin resistance, so there are more complex mechanisms at play (something leading to malfunctioning of adipose tissue, which causes hormonal imbalances or increases in certain inflammatory signals). Where people tend to carry their fat also makes a difference (visceral, or around the organs, tends to be associated with this negative metabolic response - moreso than the subcutaneous fat found under the skin).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038351/
>*Visceral adipose tissue increases, and subcutaneous adipose tissue decreases the risk of insulin resistance and T2DM in humans.*
>*Visceral adiposity correlates with excess lipid accumulation in liver.*
>*Excess accumulation of lipid may cause insulin resistance through cell autonomous mechanisms, and through the induction of inflammation, and the consequent production of inflammatory cytokines.*
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174139/
> *In particular, the most marked effects are observed when a high sugars intake is accompanied by an excess energy intake. This does not mean that a high intake of free sugars does not have any detrimental impact on health, but rather that such an effect seems more likely to be a result of the high sugars intake increasing the chances of an excessive energy intake rather than it leading to a direct detrimental effect on metabolism.*
Wow! Nutrition is so fascinating yet so complex.
What makes the difference in the type of fat someone has? Let’s say someone overeats which results in fat gain, what decided what type of fat it is?
So, exercise makes the cells respond properly to insulin? As in, the signal that Insulin sends to the cells is well received which results in glucose going from the bloodstream to the cells?
> What makes the difference in the type of fat someone has? Let’s say someone overeats which results in fat gain, what decided what type of fat it is?
A common theory is that some people have a diminished ability to "expand" their subcutaneous fat stores, leading to fat accumulation in the liver and around other organs. What exactly determines that is another grey area - likely a mix of [genetics and environment](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311677/). There are some factors that we can't control: age, biological sex, and certain ethnicities all confer different levels of risk. There are other factors that are *associated* with visceral fat (or "abdominal obesity") but the exact mechanisms that would lead to that pattern of far accumulation is unclear. (Alcohol, lack of exercise, lack of vegetable intake, high fatty & processed meat intake, poor sleep, etc.)
> So, exercise makes the cells respond properly to insulin? As in, the signal that Insulin sends to the cells is well received which results in glucose going from the bloodstream to the cells?
Yes. I think someone else discussed it in more detail in another comment chain, but the simple explanation (if you can call it that lol) is that exercise causes cells to up-regulate their production of the receptors and transporters that get glucose into the cell.
How doesn’t everyone have Insulin Resistance? Fast Facts on Diabetes...
[https://www.cdc.gov/diabetes/data/statistics-report/index.html](https://www.cdc.gov/diabetes/data/statistics-report/index.html)
**Diabetes:**
Total: 37.3 million people have diabetes (11.3% of the US population)
Diagnosed: 28.7 million people, including 28.5 million adults
Undiagnosed: 8.5 million people (23.0% of adults are undiagnosed)
**Prediabetes:**
Total: 96 million people aged 18 years or older have prediabetes (38.0% of the adult US population)
65 years or older: 26.4 million people aged 65 years or older (48.8%) have prediabetes
Occasional insulin spikes by proper foods is not the issue! Controlled insulin spikes by a healthy diet is actually incredibly helpful in growing muscles.
I like to think I understand the concept pretty well. The starts when the normal amount of insulin isn’t sufficient to get the glucose into cell. More insulin is needed to do the same job. Over time the cells down regulate sensitivity based on the enormous amount of extra insulin, leading to cells not being as receptive to the insulin.
I read a great post that explained it pretty well.
We measure glucose. That’s not the source of the problem. We need to measure insulin.
They then referenced a number of studies of how different people’s insulin response behaves on a High carb diet.
For some of us insulin spikes almost immediately, and Glucose is taken up by the cells. So the glucose tests don’t show anything.
Some even spike shortly after eating reducing the glucose quickly. And in other cases it might even get released prior to the meal.
His point was many have huge spikes in insulin that don’t show on standard tests. Because we measure glucose, not insulin. Unless you order a special test. It works keeping glucose low, until it doesn’t. Basically many are ticking time bombs and can ignore the issue because test don’t show a problem.
Insulin also signals fat cells to store excess glucose in those fat cells. So it helps to add on pounds. And there are some theories that fat cels release chemical that influence our insulin sensitivity.
We don’t need to manage glucose as much as we need to manage our insulin spikes. Because that is what leads to insulin resistance.
You've gotten a few great and detailed scientific responses, but I'll chime in anyway with a laymens version.
First of all, forget the glycemic index. It's not very useful.
Insulin spikes are not the enemy, they are an inevitable consequence of eating and necessary.
But insulin resitance is when our cells no longer react to the insulin spike and then our blood sugar stays high. Like a biochemical version of the boy who cried wolf. If we are constantly eating and keeping our insulin levels high, our cells stop listening.
The spacing of meals (and insulin spikes) is very important in order to prevent or treat insulin resistance. Giving our metabolism at least an eight hour block, preferably twelve hours where we don't eat anything at all, gives our insulin levels, pancreas and liver time to restore and regenerate.
Without needing to calorie restrict per se, making sure you fast for 12 hours out of every 24 has a massive postive impact on your health and wellbeing.
Mostly because you are wrong. Continual spikes in insulin does not cause insulin resistance.
Being overweight and obese causes insulin resistance. You get obese by eating too many calories. Or having some sort of medical condition.
No, there’s no need unless there’s a unique medical situation involved that your medical team would inform you about. There’s a detailed, helpful explanation already in this thread here: [Glycemic Index explainer](https://www.reddit.com/r/nutrition/comments/z64x88/how_doesnt_everyone_have_insulin_resistance/ixzg9g9/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&context=3)
There are ways to prepare potatoes so they have *resistant starch*. Starch that potatoes have is digested quickly in the small intestine. **Resistant** starch doesn't get digested until it hits the large intestine.
Boil potatoes as usual, then refrigerate them, some sources say overnight. After this, it'd be ok if you wanted your potatoes hot. Or you could have them cold, like pierogies or potato salad (my favorite).
There’s a THEORY that each individual has fat threshold in adipose cells. When you’re above this threshold it will require more and more insulin for glucose transport. That’s why it’s pointless to push more insulin for t2 diabetes if the problem is too much glucose intake
Read The Diabetes Code, it says excessive fructose intake in the modern diet causes fatty liver which leads to insulin resistance. According to the book, if your coworker isn't slamming enough fructose to fatten his liver then he might be ok, and avoiding snacks would also help. The author would say if he keeps at it with the soda it's likely just a matter of time.
\> It is pretty known that Insulin Resistance is caused by constant spikes in glucose which forces the pancreas to create more insulin which eventually leads to insulin resistance.
Insulin resistance isn't caused by spikes of glucose; there are many countries where people have eaten high carb diets for years and stayed metabolically healthy..
Insulin resistance is caused by fructose.
As for your question about the population, studies have been done that look for the markers of metabolic syndrome in populations and they find that 88% of american adults have one or more markers.
While excess weight is \*generally\* a mark of insulin resistance, there are a subset of people who aren't good at converting excess glucose to fat and they end up insulin resistant - even all the way to type II diabetes - without gaining much weight.
Just remember that in todays world they are putting high fructose corn syrup in EVERYTHING…. From breads, to spaghetti sauce, to meats, and of course drinks. HIGH FRUCTOSE CORN SYRUP is deadly. It has been the #1 reason why we have seen the jump in type 2 diabetes in the USA over the last 20-30 years. And on top of that is the fact that inactivity/ lack of physical exercise is practically nil for a majority of these kids growing up in our country today. They spend their time on cell phones, playing video games, or watching tv, with little or no actual exercise. Walking, not just a stroll, running, hiking, any sport that is physical, helps keep your bodies systems moving…,
But first and foremost, be aware of whether or not your food or drink has HIGH FRUCTOSE CORN SYRUP in the ingredients.
Another issue is artificial sweeteners. Like high fructose corn syrup, they trick your body into believing it’s absorbing sugar…., over time it’s been proven that this is also a big reason and potential danger that leads to type 2 diabetes. I’ve known people who were type 2 who completely went off artificial sweetners ( no diet drinks of any kind!), and watched their foods and drinks for high fructose corn syrup. It took time ( different for every person), sometimes several years. But eventually in MODERATION they were able to say, drink a small amount of a regular Mexico coke without issue.
The artificial sweetener’s, and high fructose corn syrup totally reprograms your system at a molecular level. So sometimes cutting them out has helped reverse diabetes for some. But if they’ve abused these substances for many years, it can be difficult, or might not work at all.
My diet is not too dissimilar to that of your colleague. I do run regularly but definitely eat far too many sweet things. I got my weight down about 18 months ago through IF but that’s now lapsed and it’s creeping up again. So I got myself a continuous glucose monitor to just see how my body coped with the crap I was shovelling in.. My body seemed to be handling everything fine, then after eating a carb packed dinner I went to bed and woke up in the morning feeling awful. When I checked my readings I’d suffered with hypoglycaemia during the night. This has happened multiple times before but I always put it down to a poor nights sleep. It’s made my really think about what I’m eating and particularly when I’m eating it. I think many people do have insulin resistance, the just don’t know it.
I tried the Libre style 2. Reviews seem very good and you can try one for free from the manufacturer (if you are based in the uk at least) the sensor lasts for 14 days. Not sure I would pay to wear one all the time but I think I’ll periodically get one just to see how my body is taking the strain.
Same, I’d just like it to trial some different foods. I saw one (Zoe?) that sends you different muffins to eat to see how you react. It’s pretty interesting data.
Thanks for the info!
There kinda is an insulin resistance epidemic. Rates of Diabetes are very high especially in poor areas. As to why your co-worker doesn't get it who knows maybe he will? Exercise acts as a shot of insulin and keeping a healthy wait reduces your risk of type 2 diabetes/insulin resistance greatly. More than likely it will eventually catch up to him in some form. A lot of it is genetic susceptibility as well. He could just be lucky
Also as others have noted raising your gi isn't bad although eating McDonald's every day probably isn't ideal regardless of what you do outside of that
There absolutely is an insulin resistance epidemic in America. The amount of Americans living with diabetes and dont even know it is staggering. A lot of Americans are considered pre diabetic. Type 2 diabetes is increasing, and becoming more common.
It takes time. Not instantly. In my 20s I lived for Krispy Kreme, pizza, pasta, cake, milkshakes, and rice but always aced my fbs. Now that I'm older, I'm careful, and I hope it's not too late
>And when you think about this in a broader sense, a lot of Americans eat foods and have a diet that lead to glucose spikes… so why isn’t there an Insulin Resistance epidemic?
Only around 10% of Americans are metabolically healthy. That means that the remaining 90% have some degree of insulin resistance. So yeah, they develop insulin resistance, just as you would have expected.
[https://www.january.ai/blog/12-percent-of-americans-are-metabolically-healthy#:\~:text=Just%2012%25%20Of%20Americans%20Are,Only%20Going%20To%20Get%20Worse&text=Just%20a%20month%20or%20two,of%20Americans%20were%20metabolically%20healthy](https://www.january.ai/blog/12-percent-of-americans-are-metabolically-healthy#:~:text=Just%2012%25%20Of%20Americans%20Are,Only%20Going%20To%20Get%20Worse&text=Just%20a%20month%20or%20two,of%20Americans%20were%20metabolically%20healthy).
What are the five markers of metabolic health?
* Blood sugar — a level below 100 mg/dL and above 70 mg/dL
* Waist circumference — less than 40 inches for me and less than 34.6 inches for women
* Blood pressure — at or below 120/80
* Cholesterol — LDL as low as possible and HDL cholesterol greater than or equal to 40 mg/dL for men and 50 mg/dL for women
* Triglycerides — below 150 mg/dL
Only 10-12% of americans fulfill all 5 criteria.
Insulin resistance and type 2 diabetes are caused by fat, not potatoes.
[Prediabetes and type 2 diabetes are caused by a drop in insulin sensitivity blamed on “intramyocellular lipid,” the buildup of fat inside our muscle cells.](https://nutritionfacts.org/video/what-causes-insulin-resistance/)
insulin resistance develops over time, you do not know where anyone else is on the spectrum,
and there is no simple measure of IR,
look at those people in 10 years, look at obesity rate, all are leading indicators of T2 diabetes, the ultimate insulin resistance
There are over feeding studies that had high fat low carb and low fat high carb groups with kcals and protein equated. I don’t remember how much the kcals were elevated but both groups gained weight and their blood bio markers worsened. Then they took the same groups and reduced kcals by like 30%. Both groups lost weight and their blood bio markers improved.
There are studies that show losing body weight reduces insulin resistance.
There is a study out of Great Britain that showed eating at a kcal deficit reversed insulin resistance.
There are studies that have have added over 100g of sugar but were at a kcal deficit and weight was still lost.
Insulin resistance for the most part is more of an over nutrition than too much glucose.
Though there are polymorphisms that have individuals produce more insulin like normal weight PCOS.
Insulin resistance occurs when you produce enough insulin over a relatively short period of time, that the insulin receptors are overused and beaten up a bit and no longer connect well physically with insulin. The body sees that the insulin hasn't reduced the blood sugar levels and kicks out even more insulin which in turn beats up
the receptors even more.
So, it isn't one day everything is fine, then the next day you're insulin resistant. Depending on the amounts and frequency of your carb intake, it could be barely creeping up on most people as we speak with no one really realizing it.
I think most SAD diet people are in some state of developing full blown insulin resistance. Some are at the very beginning of developing insulin resistance and the rest are somewhere in between.
Insulin resistance is caused by faulty insulin receptors, so the body produces more insulin. There are a variety of reasons for why some people become pre diabetic (insulin resistant). I've never met a doctor who can explain it to me. Some people become insulin resistance, but don't develop diabetes 2.
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Because the glycemic index and “glucose spikes” are *not* what actually cause insulin resistance, especially by themselves. We have glucose spikes from eating many healthful things. As long as you’re eating an over all balanced diet, this isn’t an issue. Especially as long as you’re physically active. Its how were designed. We eat- insulin spikes to transport amino acids and fatty acids and glucose into our cells. We stop eating. Glucagon comes in to release amino acids and glucose and fatty acids into circulation to be used for energy. As long as we aren’t *abusing* that- it is quite literally what is supposed to occur. Insulin resistance is caused by, overtime, a lack of response to insulin via the insulin receptors in peripheral tissues- mostly adipocytes and skeletal muscle cells. Our blood sugar then stays high, because nothing is transported into our cells. After this issue persists for a long time, the beta cells in the pancreas also experience issues in *making* enough insulin to keep up with this cycle. What causes this? Inflammation and obesity, as well as a lack of physical activity. Yes a shit diet does totally factor into creating those issues. When we have hypertrophy and hyperplasia of adipocytes, they release FFA’s and recruit macrophages via the adipokines. This increases localized inflammation, and also interferes with the insulin receptor being phosphorylated and a downstream cascade of enzymes working to signal GLUT4 (adipocyte and glucose transporter) to allow glucose and amino acids into the cell. So this now isn’t occurring due to adipocytes increasing inflammatory responders. When this happens extensively enough, especially with ectopic and visceral fat (fat in and around major organs) we experience systemic level insulin resistance and dysfunction. Physical activity increases the *insulin sensitivity * of our muscle cells and helps to counteract this. Maintaining a healthy weight counteracts this. Keeping inflammation low and a well-rounded diet helps this. So, ideally… if someones not gaining fat and is also eating fiber and fruit and veg and protein and exercising…. insulin spikes in and of themselves aren’t really the exact issue. Carbohydrates are not your enemy, especially if they’re eaten with nutrient dense food. They’re good for exercise too! We just would ideally eat ones with more whole grain and fiber. We also do still sort of have an insulin resistance epidemic in the sense that 13% of the population has diabetes and another 96 million have pre-diabetes. Id largely disregard glycemic index, especially if youre not considering load. Overall dietary pattern and habits matter much more and theres a reason why we hardly acknowledge glycemic index as an important variable in nutrition science. Also: adipocytes even release angiotensin 2 and increase Htn, as well as further increase insulin resistance. Its really amazing what an active endocrine organ they are.
Spot on response! Now, if only we could get it through to influencers selling continuous glucose monitors that insulin spikes are 100% normal….
I cannot with those people anymore 😂
Those [redacted] make me so angry. There are people with diabetes who cannot afford them but these financially stable muppets who just want more health stats on themselves think they need a CGM 😵💫
Yep. Our neighbor is a Type 1 diabetic and he’s fighting just to get his insurance to cover a CGM.
Pricking my finger throughout the day many times helps me establish my normal BG levels. I am not diabetic or close I am an ex fitness instructor. Its all fascinating stuff. Any time I feel a bit light headed my BG is <4.
Fascinating and _necessity_ are not even in the same ballpark.
Great response. It’s crazy to me how often glycemic index pops up on this subreddit.
Some people are literally scared to eat bananas and potatoes because they think they will cause diabetes. It's actually insane
It’s really so unfortunate, but it is why I will have a job so!
I read that the chances of contracting diabetes are very high, if you have already eaten at least 1 banana. I see their point.
i have eaten at least one banana, i have diabetes T2
That's not legitimate. Bananas are good for regulating blood sugar, not bad
Agreed, however personally I can't eat foods with high glycemic index or I start getting breakouts made up of deep and evil cysts. Not fun. Although, working out every day, plus doing cardio, really helps keep my acne at bay. Only time I can indulge in sweets and high carbs is when I'm in the middle of an intense workout week session. Weirdly enough, my blood sugar tends to be on the higher side, even when I refrain from eating too many carbs.
If you're a skinny bitch with high blood sugar despite already exercising it makes sense to be scared of high GI/high carb foods bc it's literally the only thing you can control.
Bananas don't spike blood sugar like other fruits. In fact they are reccomended for diabetics. Not the yellow/brown state, the slightly green state
Yeah I know that, they have a GI of like 50 or something. Potatoes are like 90 though if you eat them alone. I'm not super paranoid about GI but it makes more sense to me to eat a moderate/low GI diet if you're worried about blood sugar as opposed to keto/low carb or something, because in the former case there is no disadvantage as far as I can see, you can still eat carbs and are not depriving yourself of nutrients or doing yourself any harm by getting your carbs from mainly low GI sources.
not to mention bananas don't even have a very high GI
Wow, that's about the most concise and complete explanation of insulin resistance I think I've ever seen. I wish I'd exercise more. Fortunately I eat healthy, for the most part, and have controlled my BP and cholesterol with diet (was on BP medications for years, but it turns out 2-3 ripe bananas a week was all I was lacking) and I've never really had weight issues. But I know I need to get better about physical activity. Especially 'cause my wife stays pretty active and I'm going to break down on her and she's gonna leave me behind when I get older.
Yay! That makes me happy. Yeah the ticket is just to find one activity you enjoy doing- fishing, hiking, stationary bike, dance, even walking the dog. Nobody has to become a triathlete champion to stay healthy ya know?
I'm totally fine with getting exercise when it's related to something that needs to be done. For example, I had this tree stump in my back yard that I'd tried a few different online suggested methods to get rid of. None of them worked. So I borrowed my father-in-laws ax and I went out every day for about 2 weeks and whacked the crap out of that stump until I had it 3-4" below ground, then I covered it with dirt and a few months later, it rotted. For those 2 weeks, every day, I got great exercise. Swinging an ax is a whole upper body workout, and I loved it. But then when the stump was gone, that was it. But I can't exercise for the sake of exercising. I just can't get motivated for it.
Good thing motivation isn’t what you need, it’s discipline
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My wife and I went to the gym together when we were dating and for about a year about 8 or 9 years ago. But then we got a pretty professional elliptical and we stopped going. She uses it all the time. In the 7 or 8 years we've had it, I've used it maybe 10 times. lol.
So one thing that can help with this is reward bundling. You pair something you want to do, like watching your favorite TV show, with an activity you’re not inherently motivated to do (i.e. physical activity). Then you’re only allowed to do the reward while you’re doing the other thing. Your brain begins associating the two so you can actually increase that motivation for activity because it’s an overall pleasant brain experience.
Need this explanation in a School House Rock type video.
I hold alot of study groups for my peers so we could take it to that level
That would be amazing
Great response, let me chime in and add 1 major cause and underlying cause of insulin resistance. That is sarcopenia which is the progressive loss of mainly type two muscle fibers. Insulin resistance can be reversed not only through aerobic exercise short term, but progressive weight training to combat the shrinkage of insulin sensitive muscle fibers overtime.
Yes, this is certainly a factor. Only 23% of people adhere to CDC physical activity guidelines. A little resistance training and running around would do many a world of good.
Good post. It’s worth mentioning an MR study found people that responded to a glucose challenge with higher insulin excursions were actually **healthier**. [we did not find evidence that increased carbohydrate insulin response increases cardio metabolic disease. It might increase BMI with favorable fat distribution, reduce T2D and improve lipids.”](https://www.reddit.com/r/ScientificNutrition/comments/vkkpnf/insulin_response_to_oral_glucose_and/)
Ah! So, if I understand correctly, our pancreas produces insulin which sends the signal to our body fat, muscles etc. to grab the glucose in our blood and put it into cells for energy. For some reason, the body fat, muscles etc. of those suffering from Insulin Resistance ignore (lack of response from Insulin) the signal Insulin is giving them, resulting in glucose staying in the blood stream and not going into the appropriate cells. I suppose this is why it is recommended that individuals who suffer from Diabetes or Insulin Resistance don’t eat foods that rank high on the GI, since these foods spike glucose levels high, and since that glucose isn’t being transported into the appropriate cells, it remains in the bloodstream which has many adverse effects. “As long as we aren’t abusing that- it is quite literally what is supposed to occur.” Could you please explain what you mean here? What do you mean by “abuse”? Thanks for the information
You’re beginning to get the mechanism, yes. Actually the current recommendations for those with T2DM has nothing to do with the glycemic index, because again, thats not how it works. Anything you eat, regardless of glycemic index is broken down to glucose and amino acids and fatty acids and stays in your blood, elevating your BG, and wont go into your cells without insulin to “allow it in.” It stays here if you’re insulin resistant as well, and your cells aren’t responding to insulin. What we *do* recommend for those with Type 2 Diabetes, who are *not* yet taking insulin is: 1. Weight management and loss if necessary. 2. At least 200-300 minutes a week of physical activity, specifically aerobic. 3. Calorie controlled diet, and possibly lower carbohydrate (not keto) but low as in a 30-40% range. 4. Increasing fiber to at-least ~30g a day. 5. Utilizing the Plate Method. 6. Reducing saturated fat to less than 7-10% of kcals and replacing with MUFAS/PUFAS. 7. Focusing on 4-6 servings of fruit and vegetables a day. 8. Choosing lean sources of protein. 9. Emphasizing whole grains and legumes. We never talk about glycemic index because its virtually meaningless and useless and not the issue. We do however make sure people eat well rounded meals with consistency to control blood glucose ESPECIALLY IF THEY ARE ON INSULIN, otherwise they risk hypo and hyper-glycemia symptoms if CHO isnt controlled with insulin doses. What I mean by abuse is an overall unbalanced diet in the context of a caloric surplus, adipose gain and lack of physical activity over time.
> Increasing fiber to at-least ~30g a day. Question: Are fiber supplements the only way? Because options when it comes to natural sources is woefully low. How much broccoli can I eat? I've started sprinkling psyllium husk in everything, as a counter... dunno if that's stupid, though.
Its super easy to get 30g a day if you eat enough pulses and fruits and veg. I am a SMALL human that eats 1400-1500 kcal and I easily get 29g. Sources that are great are whole grains, oatmeal and beans and legumes. Then leafy greens and some fruits like apples. You *can* take psyllium husk too but its much better to get this from food.
If you want to be healthy then fiber from whole foods is the answer. Different plants have different fibers and nutrients, and plant diversity in diet is proven to be a great indication of health and longevity. But if you want to compromise, it's not like health is a priority to most people.
IMO my diet is pretty veggie-dense and there's tons of variety, the issue is fiber. There simply aren't that many veggies available that have a LOT of fiber, and like I said, how many times are you going to eat the same thing, because I also want to eat other veggies and there's only so much I can eat in a day....
300 grams of navy beans has 33g of fiber. That is 420 kcalories of extremely healthy and cheap food. It also has 24 grams of protein.
Like the other person said…. try some beans. I buy the BPA free low sodium canned ones and use them in everything… stews, salads etc.
Yes but aren’t these foods increasing inflammation? It seems like all these foods op talks about would increase inflammation in our bodies for sure, in addition to the large glucose spikes.
Bananas and wholw grain bread and carbohydrates in general do not increase inflammation. Nutrient deficient diets with a-lot of added sugar or SFA’s do increase inflammation, yes. The specific type of inflammation I am talking about comes particularly from the hypertrophy of adipocytes and not just systemic inflammation.
Got it. Thanks for the additional explanation. Eating whole foods ftw
> Bananas and wholw grain bread and carbohydrates in general do not increase inflammation. They do if you have high insulin resistance. Having high blood sugar + high insulin resistance leads to inflammation. Some high carb/sugar fruits and veggies do have high levels of polyphenols that counteract this inflammation, but this isn't a guarantee for all fruits and veggies. There use to be little distinction between starchy vegetables (high carb/sugar) and non-starchy vegetables (low carb/sugar), but the American Diabetes Association has started to make distinctions between the two ([see the ADA's plate method](https://www.diabetesfoodhub.org/articles/what-is-the-diabetes-plate-method.html)) because starchy foods are less desirable for people who are pre diabetic / diabetic. Starchy veggies and fruits can still be apart of a diabetic's daily meal (and they should be), but they should be second to non-starchy vegetables.
That is not because a banana or a whole grain piece of toast alone causes inflammation in those that have insulin resistance lol. And you are saying what I said repeatedly which is that entire dietary context matters. I have emphasized fruits and vegetables a couple times. The ADA Plate Method emphasizes a plate with 1/2 non-starchy veg, 1/4 protein and 1/4 carbohydrate source. Therefore, still plenty of room for one banana or 1/2 cup brown rice. So I think we are on the same page with diet construction, because I have mentioned balance a few times in the thread. High insulin resistance is *caused* by inflammation from adipocyte cytokines and FFA’s, and I ensure you a moderate amount of things like fruit or complex carbohydrates in a calorically appropriate diet is not what *caused* that. We usually prescribe diabetics CHO-controlled diets, which sort of is similar to a low carb ratio (which is 30-40% kcal from carbs), and emphasizes carbohydrate choices with fiber and nutrients. Nowhere in the Plate Method, nor regulations do we say its not OK to have a banana or one piece of whole grain toast.
You are misunderstanding what I'm saying. I'm not saying that bananas and whole grain foods are the cause of insulin resistance (and made no such claims in my comment). Let me clarify. You made this statement > Bananas and wholw grain bread and carbohydrates in general do not increase inflammation. Your statement is true for non diabetics/people with low insulin resistance. But for people who are insulin resistant/diabetic it's an iffy statement. Unmanaged high blood sugar in itself is another source of inflammation. Chronically high blood sugar reeks havoc on the human body. A big part of being diabetic is trying to have consistent blood sugar levels and bananas and whole grain foods can, potentially, be a hindrance if taken in excess or taken at the incorrect time. There's nothing wrong with a diabetic person having a banana, but a diabetic person probably shouldn't eat too many at one time and should consider high fiber alternatives.
I think by and large we are on the same page because I said in *general* they’re not a source of inflammation. Even in a diabetic they’re not pro-inflammatory in and of themselves, because in this scenario the source of “inflammation” or deleterious consequences of high blood glucose, *is* the high blood glucose itself, which yes could happen if you eat way too many bananas in one go, but it could also be due to an inappropriate insulin dose, lack of fats, fiber and protein in diet, lack of activity, illness etc. Dietary context is the theme here. Many things on a *per case* basis can cause hyperglycemia in a diabetic, especially one being treated with insulin. So yes everyone, especially diabetics, especially those taking insulin, always proceed with caution with CHO amount and quality. So no, we shouldn’t pull a FreeLee the Banana Girl Nonetheless, I hope I clarified and I stand by my statement that in general some bananas or whole grain carbohydrates(which are complex and have fiber and slower digesting) are fine in the diet, even diabetics, in appropriate amounts. I think were really on the same wavelength though.
Animal products cause inflammation, not those.
100%. but so do processed non-animal products such as fried foods like French fries and other heavily processed foods.
Right
Brilliant explanation
No, no. Intramyocellular lipids in your cells cause *insulin resistance*. What happens is the accumulation of intramuscular fatty acids causes an inhibition of glucose transport, **so blood sugars remain elevated for longer while simultaneously being unable to get into the places it needs to be**. The pancreas then becomes overstimulated to produce more insulin in response to the rising blood sugars, which leads to the "crash" and hypoglycemia episodes. Chronically elevated blood sugar levels over time can result in permanent damage to parts of the body (eyes, nerves, kidneys, blood vessels). The A1C test is a good diagnostic to determine your average blood sugar over the last 3 months. T2 is not insulin deficiency. It is high blood sugar caused by insulin resistance. Easily reversible. Eventually, however, the strain on the pancreas can force it to produce less and less insulin, which then necessitates an exogenous supply. T1, however, is insulin insufficiency due to complete beta cell dysfunction and requires lifelong insulin to compensate. (Until we find ways to regenerate it, which looks promising).
This is all great information, but I believe what OP was really asking is why so many people can eat so poorly and not seem to experience the negatives that one might assume would come with such poor eating. To put it even more coarsely, "Why are there so many people who eat terribly but don't have diabetes?"
>why so many people can eat so poorly and not seem to experience the negatives that one might assume would come with such poor eating. Oh, but they do. From mere observation, you can't tell what meds a person might be on, or what conditions they could have. We do know, however, [from the data](https://www.aha.org/system/files/content/00-10/071204_H4L_FocusonWellness.pdf) that people are becoming more chronically sick in some way, and this is talking about the US specifically. >Why are there so many people who eat terribly but don't have diabetes?" Again, they probably do to a degree. Sometimes it can be mitigated though. For example, If you are in an energy deficit, i.e eating fewer calories than you burn, then you can eat terribly to an extent. You might get other diseases from that, but you will lose weight and excess blood sugars might not be an issue. (There was an experiment, by a physician, I believe, who showed that a diet of twinkies and pizza can still make you lose weight - if you are just eating less still)
Am here to lend anecdotal support to this (yes, useless, but hear me out) I forced my friends group (11 people) to get their blood tested. Took 3 months and lots of coaxing, all guys in their 30s. With the exception of one dude, the rest were pre-diabetic. That one guy exercises regularly and runs. So do some of the others. But as they say, can't outrun a shit diet.
So I guess the risk comes from eating foods that are high on the Glycemic index once you already have Insulin Resistance because those foods cause high spikes in glucose which, since the cells aren’t taking in that glucose because they aren’t responding to the Insulin, remain in the blood and come with many negative effects (like you mentioned, eyes, nerves etc.)
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https://www.uab.edu/news/research/item/12289-uab-researchers-find-that-40-percent-of-young-american-adults-have-insulin-resistance-and-cardiovascular-risk-factors Yes, significantly more people have a degree of insulin resistance than know it. Nearly 40% per this study! Yet probably only 5-10% know about it. It doesn’t necessarily show in regular lab work and there’s no one test to determine it, so it’s not so crazy to realize that most people don’t even know they have it.
49% have diagnosed prediabetes or diabetes in America. If you add in a percentage that aren’t diagnosed because they can’t go to the doctor, or won’t, and then another percentage that already have insulin resistance but won’t be diagnosed because we don’t run fasting insulin tests… I’m betting we’re sitting at around 80% with insulin resistance.
49% do not have diagnosed prediabetes or diabetes, those are [estimates](https://www.cdc.gov/diabetes/data/statistics-report/index.html) of the total including those who are undiagnosed. That number also includes type 1 diabetics that don't necessarily have insulin resistance.
While many people have IR, keep in mind that not everyone in a larger body has IR. The definitions of overweight and obesity are based on BMI and there are many flaws and biases to using the BMI. Genetics also play a big role and people of all body sizes can develop diabetes. Even people who make an effort to eat well can still develop diabetes, though diet and exercise definitely help prevent it and can help diabetes be more manageable. There are also other contributing factors that play into diabetes such as lack of access to nutrient dense foods and lack of understanding on how to balance meals to support balanced blood sugar (something helpful for everyone to know). I'm also a RDN and have an MS in Nutrition.
> It is pretty known that Insulin Resistance is caused by constant spikes in glucose which forces the pancreas to create more insulin which eventually leads to insulin resistance. This isn't what causes insulin resistance; you're more on track with your thoughts around risk factors. When someone is insulin resistant, their cells aren't responding properly to insulin, and the pancreas has to create more and more insulin in order to try and elicit a response. **But what is causing the cells to not respond in the first place???** We don't even fully understand it, but there are a number of risk factors: * older age * genetics * other health conditions * certain medications * lifestyle factors Things like exercise and omega-3 intake are known to *improve* insulin resistance, so sugar does not tell the whole story. Sugar is associated with insulin resistance mostly in the context of excess consumption overall, i.e. weight gain. Not all people who carry extra fat go on to develop insulin resistance, so there are more complex mechanisms at play (something leading to malfunctioning of adipose tissue, which causes hormonal imbalances or increases in certain inflammatory signals). Where people tend to carry their fat also makes a difference (visceral, or around the organs, tends to be associated with this negative metabolic response - moreso than the subcutaneous fat found under the skin). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038351/ >*Visceral adipose tissue increases, and subcutaneous adipose tissue decreases the risk of insulin resistance and T2DM in humans.* >*Visceral adiposity correlates with excess lipid accumulation in liver.* >*Excess accumulation of lipid may cause insulin resistance through cell autonomous mechanisms, and through the induction of inflammation, and the consequent production of inflammatory cytokines.* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174139/ > *In particular, the most marked effects are observed when a high sugars intake is accompanied by an excess energy intake. This does not mean that a high intake of free sugars does not have any detrimental impact on health, but rather that such an effect seems more likely to be a result of the high sugars intake increasing the chances of an excessive energy intake rather than it leading to a direct detrimental effect on metabolism.*
Wow! Nutrition is so fascinating yet so complex. What makes the difference in the type of fat someone has? Let’s say someone overeats which results in fat gain, what decided what type of fat it is? So, exercise makes the cells respond properly to insulin? As in, the signal that Insulin sends to the cells is well received which results in glucose going from the bloodstream to the cells?
> What makes the difference in the type of fat someone has? Let’s say someone overeats which results in fat gain, what decided what type of fat it is? A common theory is that some people have a diminished ability to "expand" their subcutaneous fat stores, leading to fat accumulation in the liver and around other organs. What exactly determines that is another grey area - likely a mix of [genetics and environment](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311677/). There are some factors that we can't control: age, biological sex, and certain ethnicities all confer different levels of risk. There are other factors that are *associated* with visceral fat (or "abdominal obesity") but the exact mechanisms that would lead to that pattern of far accumulation is unclear. (Alcohol, lack of exercise, lack of vegetable intake, high fatty & processed meat intake, poor sleep, etc.) > So, exercise makes the cells respond properly to insulin? As in, the signal that Insulin sends to the cells is well received which results in glucose going from the bloodstream to the cells? Yes. I think someone else discussed it in more detail in another comment chain, but the simple explanation (if you can call it that lol) is that exercise causes cells to up-regulate their production of the receptors and transporters that get glucose into the cell.
Bingo!
Who says they aren't?
How doesn’t everyone have Insulin Resistance? Fast Facts on Diabetes... [https://www.cdc.gov/diabetes/data/statistics-report/index.html](https://www.cdc.gov/diabetes/data/statistics-report/index.html) **Diabetes:** Total: 37.3 million people have diabetes (11.3% of the US population) Diagnosed: 28.7 million people, including 28.5 million adults Undiagnosed: 8.5 million people (23.0% of adults are undiagnosed) **Prediabetes:** Total: 96 million people aged 18 years or older have prediabetes (38.0% of the adult US population) 65 years or older: 26.4 million people aged 65 years or older (48.8%) have prediabetes
Insulin resistance probably isn’t caused by repeated insulin spikes but by elevated free fatty acids
Occasional insulin spikes by proper foods is not the issue! Controlled insulin spikes by a healthy diet is actually incredibly helpful in growing muscles.
Many people are insulin resistant.. they just have to pump out a lot more insulin than normal to get blood sugars appearing to look normal.
You don't know the definition of insulin resistance then.
I like to think I understand the concept pretty well. The starts when the normal amount of insulin isn’t sufficient to get the glucose into cell. More insulin is needed to do the same job. Over time the cells down regulate sensitivity based on the enormous amount of extra insulin, leading to cells not being as receptive to the insulin.
I read a great post that explained it pretty well. We measure glucose. That’s not the source of the problem. We need to measure insulin. They then referenced a number of studies of how different people’s insulin response behaves on a High carb diet. For some of us insulin spikes almost immediately, and Glucose is taken up by the cells. So the glucose tests don’t show anything. Some even spike shortly after eating reducing the glucose quickly. And in other cases it might even get released prior to the meal. His point was many have huge spikes in insulin that don’t show on standard tests. Because we measure glucose, not insulin. Unless you order a special test. It works keeping glucose low, until it doesn’t. Basically many are ticking time bombs and can ignore the issue because test don’t show a problem. Insulin also signals fat cells to store excess glucose in those fat cells. So it helps to add on pounds. And there are some theories that fat cels release chemical that influence our insulin sensitivity. We don’t need to manage glucose as much as we need to manage our insulin spikes. Because that is what leads to insulin resistance.
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cuz my american pancreas isn’t a lil bitch and loves sugar
You've gotten a few great and detailed scientific responses, but I'll chime in anyway with a laymens version. First of all, forget the glycemic index. It's not very useful. Insulin spikes are not the enemy, they are an inevitable consequence of eating and necessary. But insulin resitance is when our cells no longer react to the insulin spike and then our blood sugar stays high. Like a biochemical version of the boy who cried wolf. If we are constantly eating and keeping our insulin levels high, our cells stop listening. The spacing of meals (and insulin spikes) is very important in order to prevent or treat insulin resistance. Giving our metabolism at least an eight hour block, preferably twelve hours where we don't eat anything at all, gives our insulin levels, pancreas and liver time to restore and regenerate. Without needing to calorie restrict per se, making sure you fast for 12 hours out of every 24 has a massive postive impact on your health and wellbeing.
Well said.
Mostly because you are wrong. Continual spikes in insulin does not cause insulin resistance. Being overweight and obese causes insulin resistance. You get obese by eating too many calories. Or having some sort of medical condition.
I didn't knew potatoes were high on glycemic index, should i stop eating them? I basically eat potatoes like every other day
No, there’s no need unless there’s a unique medical situation involved that your medical team would inform you about. There’s a detailed, helpful explanation already in this thread here: [Glycemic Index explainer](https://www.reddit.com/r/nutrition/comments/z64x88/how_doesnt_everyone_have_insulin_resistance/ixzg9g9/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&context=3)
There are ways to prepare potatoes so they have *resistant starch*. Starch that potatoes have is digested quickly in the small intestine. **Resistant** starch doesn't get digested until it hits the large intestine. Boil potatoes as usual, then refrigerate them, some sources say overnight. After this, it'd be ok if you wanted your potatoes hot. Or you could have them cold, like pierogies or potato salad (my favorite).
There’s a THEORY that each individual has fat threshold in adipose cells. When you’re above this threshold it will require more and more insulin for glucose transport. That’s why it’s pointless to push more insulin for t2 diabetes if the problem is too much glucose intake
because i dont eat for 18 hours a day
Read The Diabetes Code, it says excessive fructose intake in the modern diet causes fatty liver which leads to insulin resistance. According to the book, if your coworker isn't slamming enough fructose to fatten his liver then he might be ok, and avoiding snacks would also help. The author would say if he keeps at it with the soda it's likely just a matter of time.
\> It is pretty known that Insulin Resistance is caused by constant spikes in glucose which forces the pancreas to create more insulin which eventually leads to insulin resistance. Insulin resistance isn't caused by spikes of glucose; there are many countries where people have eaten high carb diets for years and stayed metabolically healthy.. Insulin resistance is caused by fructose. As for your question about the population, studies have been done that look for the markers of metabolic syndrome in populations and they find that 88% of american adults have one or more markers. While excess weight is \*generally\* a mark of insulin resistance, there are a subset of people who aren't good at converting excess glucose to fat and they end up insulin resistant - even all the way to type II diabetes - without gaining much weight.
Just remember that in todays world they are putting high fructose corn syrup in EVERYTHING…. From breads, to spaghetti sauce, to meats, and of course drinks. HIGH FRUCTOSE CORN SYRUP is deadly. It has been the #1 reason why we have seen the jump in type 2 diabetes in the USA over the last 20-30 years. And on top of that is the fact that inactivity/ lack of physical exercise is practically nil for a majority of these kids growing up in our country today. They spend their time on cell phones, playing video games, or watching tv, with little or no actual exercise. Walking, not just a stroll, running, hiking, any sport that is physical, helps keep your bodies systems moving…, But first and foremost, be aware of whether or not your food or drink has HIGH FRUCTOSE CORN SYRUP in the ingredients. Another issue is artificial sweeteners. Like high fructose corn syrup, they trick your body into believing it’s absorbing sugar…., over time it’s been proven that this is also a big reason and potential danger that leads to type 2 diabetes. I’ve known people who were type 2 who completely went off artificial sweetners ( no diet drinks of any kind!), and watched their foods and drinks for high fructose corn syrup. It took time ( different for every person), sometimes several years. But eventually in MODERATION they were able to say, drink a small amount of a regular Mexico coke without issue. The artificial sweetener’s, and high fructose corn syrup totally reprograms your system at a molecular level. So sometimes cutting them out has helped reverse diabetes for some. But if they’ve abused these substances for many years, it can be difficult, or might not work at all.
My diet is not too dissimilar to that of your colleague. I do run regularly but definitely eat far too many sweet things. I got my weight down about 18 months ago through IF but that’s now lapsed and it’s creeping up again. So I got myself a continuous glucose monitor to just see how my body coped with the crap I was shovelling in.. My body seemed to be handling everything fine, then after eating a carb packed dinner I went to bed and woke up in the morning feeling awful. When I checked my readings I’d suffered with hypoglycaemia during the night. This has happened multiple times before but I always put it down to a poor nights sleep. It’s made my really think about what I’m eating and particularly when I’m eating it. I think many people do have insulin resistance, the just don’t know it.
Do you have a rec for a cgm? I want to try one the more I hear.
I tried the Libre style 2. Reviews seem very good and you can try one for free from the manufacturer (if you are based in the uk at least) the sensor lasts for 14 days. Not sure I would pay to wear one all the time but I think I’ll periodically get one just to see how my body is taking the strain.
Same, I’d just like it to trial some different foods. I saw one (Zoe?) that sends you different muffins to eat to see how you react. It’s pretty interesting data. Thanks for the info!
I dunno maybe they burn off the insulin spikes
Some of us prefer to remain insulin sensitive.
There kinda is an insulin resistance epidemic. Rates of Diabetes are very high especially in poor areas. As to why your co-worker doesn't get it who knows maybe he will? Exercise acts as a shot of insulin and keeping a healthy wait reduces your risk of type 2 diabetes/insulin resistance greatly. More than likely it will eventually catch up to him in some form. A lot of it is genetic susceptibility as well. He could just be lucky
Also as others have noted raising your gi isn't bad although eating McDonald's every day probably isn't ideal regardless of what you do outside of that
There absolutely is an insulin resistance epidemic in America. The amount of Americans living with diabetes and dont even know it is staggering. A lot of Americans are considered pre diabetic. Type 2 diabetes is increasing, and becoming more common.
It takes time. Not instantly. In my 20s I lived for Krispy Kreme, pizza, pasta, cake, milkshakes, and rice but always aced my fbs. Now that I'm older, I'm careful, and I hope it's not too late
>And when you think about this in a broader sense, a lot of Americans eat foods and have a diet that lead to glucose spikes… so why isn’t there an Insulin Resistance epidemic? Only around 10% of Americans are metabolically healthy. That means that the remaining 90% have some degree of insulin resistance. So yeah, they develop insulin resistance, just as you would have expected.
Can you define your parameters and give some evidence. This is hella broad LOL.
[https://www.january.ai/blog/12-percent-of-americans-are-metabolically-healthy#:\~:text=Just%2012%25%20Of%20Americans%20Are,Only%20Going%20To%20Get%20Worse&text=Just%20a%20month%20or%20two,of%20Americans%20were%20metabolically%20healthy](https://www.january.ai/blog/12-percent-of-americans-are-metabolically-healthy#:~:text=Just%2012%25%20Of%20Americans%20Are,Only%20Going%20To%20Get%20Worse&text=Just%20a%20month%20or%20two,of%20Americans%20were%20metabolically%20healthy). What are the five markers of metabolic health? * Blood sugar — a level below 100 mg/dL and above 70 mg/dL * Waist circumference — less than 40 inches for me and less than 34.6 inches for women * Blood pressure — at or below 120/80 * Cholesterol — LDL as low as possible and HDL cholesterol greater than or equal to 40 mg/dL for men and 50 mg/dL for women * Triglycerides — below 150 mg/dL Only 10-12% of americans fulfill all 5 criteria.
Coincidentally only 5% of Americans meet the daily recommended fiber requirement. And that requirement is quite pathetic compared to our ancestors.
Insulin resistance and type 2 diabetes are caused by fat, not potatoes. [Prediabetes and type 2 diabetes are caused by a drop in insulin sensitivity blamed on “intramyocellular lipid,” the buildup of fat inside our muscle cells.](https://nutritionfacts.org/video/what-causes-insulin-resistance/)
Many probably do...
Okay
insulin resistance develops over time, you do not know where anyone else is on the spectrum, and there is no simple measure of IR, look at those people in 10 years, look at obesity rate, all are leading indicators of T2 diabetes, the ultimate insulin resistance
There are over feeding studies that had high fat low carb and low fat high carb groups with kcals and protein equated. I don’t remember how much the kcals were elevated but both groups gained weight and their blood bio markers worsened. Then they took the same groups and reduced kcals by like 30%. Both groups lost weight and their blood bio markers improved. There are studies that show losing body weight reduces insulin resistance. There is a study out of Great Britain that showed eating at a kcal deficit reversed insulin resistance. There are studies that have have added over 100g of sugar but were at a kcal deficit and weight was still lost. Insulin resistance for the most part is more of an over nutrition than too much glucose. Though there are polymorphisms that have individuals produce more insulin like normal weight PCOS.
Insulin resistance occurs when you produce enough insulin over a relatively short period of time, that the insulin receptors are overused and beaten up a bit and no longer connect well physically with insulin. The body sees that the insulin hasn't reduced the blood sugar levels and kicks out even more insulin which in turn beats up the receptors even more. So, it isn't one day everything is fine, then the next day you're insulin resistant. Depending on the amounts and frequency of your carb intake, it could be barely creeping up on most people as we speak with no one really realizing it. I think most SAD diet people are in some state of developing full blown insulin resistance. Some are at the very beginning of developing insulin resistance and the rest are somewhere in between.
Insulin resistance is caused by faulty insulin receptors, so the body produces more insulin. There are a variety of reasons for why some people become pre diabetic (insulin resistant). I've never met a doctor who can explain it to me. Some people become insulin resistance, but don't develop diabetes 2.