A2 magazine and Dr. Nedic explain the exact nature of Insulin Resistance and its effect on Diabetes …
A Small step away from Diabetes
The Insulin resistance condition is now of epidemic proportions in South Africa. Dr Sly Nedic explains the exact nature of the beast and covers the cause and effects of the illness
Insulin resistance has been something of a buzz word in past couple of years for anyone who wants to lose stubborn abdominal fat, with gym addicts, dieticians and doctors all trying to fight it.
But it’s not a simple weight-loss issue – it’s much more serious than that. Insulin resistance is a medical epidemic in developed countries, and it affects all generations. We need to create awareness in the general population in order to stop it. It’s reversible, but if it’s left untreated, insulin resistance progresses to type 2 diabetes.
Recent statistics show that 10 million people in the US suffer from type 2 diabetes and another half a million are believed to be undiagnosed. South Africa is not any different to the rest of the world; our obesity and diabetic figures are comparable with those in the US.
So, what exactly is insulin resistance (IR)? It is a pathological (ie. abnormal) condition in which the body’s naturally produced hormone, insulin, becomes less effective in lowering blood sugar levels. In the muscle and fat cells, IR reduces glucose uptake, which leads to the starvation of those cell. In the liver it reduces the way glucose is processed and stored.
If you can address IR and type 2 diabetes before the beta cells of the pancreas are irreversibly damaged, both conditions can be successfully treated. But this must be addressed by a medical doctor trained in integrative medicine.
Obese people don’t necessarily have IR and though it is usually present in patients with stubborn abdominal fat, sometimes people with a normal body weight and BMI (body mass index) are found to have IR. However, since IR and stubborn abdominal fat usually go hand in hand, patients become very aware of the aesthetic part of this condition – and often seek help from aesthetic doctors. These doctors must inform patients about the dangerous effects of abdominal obesity. They must refer them for treatment of the underlying condition, together with any aesthetic procedures to be performed
IR with abdominal fat is associated with metabolic syndrome and cardiovascular disease, breast, prostate and colon cancer, depression, erectile dysfunctions, polycystic ovarian syndrome, and so on.
The problem is that it usually includes internally situated visceral fat, which is metabolically active. This means that there is fat surrounding the internal organs, and that fat produces its own hormones and other chemicals. Symptoms are in the beginning vague and non-specific – fatigue, inability to focus, increased hunger, sleepiness after meals, intestinal bloating, mild depression, weight gain (especially in the abdominal area), and inability to lose weight while dieting.
There are a couple of mechanisms involved with the pathophysiology of IR – in other words, a few things work together to result in the condition: excess energy intake, which overwhelm the metabolic pathways mainly due to eating high levels of carbohydrates and high saturated fats. This all gets more complicated by the sedentary lifestyle that is typical of developed countries.
There are also hormones that are overproduced due to on-going stress, which come from different origins (emotional, nutritional, chemical, physical and hormonal). Cortisol is the main hormone behind the scenes that needs to be regulated in order to fight the IR.
Therefore it’s easy to see, that a multifactorial but personalised approach is the key to successfully treating insulin resistance. Addressing only the aesthetic problem of stubborn abdominal fat will not give successful results.
The patient needs to be medically diagnosed, as insulin resistant and the relevant treatment must be applied by medical doctors trained in integrative medicine. Different stages of IR require different supplementation in order to reverse the process, and removal of abdominal fat will happen simultaneously.