LifeCare Chiropractic

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insulin resistance

Which Comes First? Abdominal Fat or Prediabetes?

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Which comes first?  The insulin reistant chicken or the egg with abdominal fat?

To a certain degree, the answer doesn’t really matter all that much because the answer (lifestyle changes) is the same in either case.  But it may change the perspective on which we view the condition of obesity and diabetes.  Diabetics and overweight people are constantly being told they need to take off weight to be healthier.

Unfortunately, the reality of the way our bodies work is the opposite of this common misconception.

I have always told patients that taking off weight is a side effect of taking better care of yourself.  The key is to not focus on the weight.

This particular study supports this idea, AND shows just how fast the fecal matter hits the physiological fan.

In just 28 days of taking in too many calories (1250 extra calories / day) in healthy adults set up prediabetes / insulin resistance without accompanying inflammation in the abdominal tissue.  The insulin resistance in the abdominal fat will then lead to more fat and subsequent inflammation.  THEN things get progressively, rapidly worse.

In other words, excess fat in the abdominal region is the secondary consequence of taking in too many calories.  It is only later that inflammation and abdominal fat starts to accumulate.

Asymmetric Dimethylarginine, Blood Pressure, and Renal Perfusion – (04-16-03)

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Asymmetric Dimethylarginine, Blood Pressure, and Renal Perfusion.

ADMA is still a relatively new concept. Basically, it is the arch-villian to nitric oxide. Recall that nitric oxide is a potent vasodilator and helps to lower blood pressure. When ADMA levels are high, it overrides the vasodilator effects of NO and raises blood pressure. Here we see that, in elderly patients, ADMA levels were directly correlated with blood pressure. Keep in mind that ADMA levels rise with insulin resistance (higher insulin inactivates the enzymes that degrades ADMA levels; essentially raising levels of ADMA) and insulin resistance climbs as we get older due to muscle loss.

Circulation — Abstracts: Kielstein et al. 107 (14): 1891

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Cortisol and the metabolic syndrome in South Asians – (04-16-03)

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Cortisol and the metabolic syndrome in South Asians.

Until the day I quit practising (or die, whichever comes first…) I will always come across patients who skip breakfast in an attempt to lose weight. And, like a robot, I go on to explain that this is probably one of the absolute worst things they can do to lose weight. Remember that the brain needs fuel, and if you deprived the brain of fuel through your diet, cortisol will be secreted to break down lean muscle mass to get the glucose of the brain. Less muscle mass = worsening of insulin resistance and weight gain. This article once again illustrates the intimate connection between insulin and cortisol and the snowball effect one has on the other.

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Growth Hormone Replacement Therapy Induces Insulin Resistance – (04-16-03)

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Growth Hormone Replacement Therapy Induces Insulin Resistance.

While this article address growth hormone as used for true deficiency states, this illustrates one of the primary dangers with many so called “anti aging” miracle supplements. Growth hormone has been big on this front for many years. However, remember that Mother Nature does things for a reason. The lowering of hormone production as we get older is done as a protective mechanism. So, naturally, when we go mess with Mother Nature with things like growth hormone and HRT than side effects that can be life threatening are fair game on the side effects list.

JCEM — Abstracts: Bramnert et al. 88 (4): 1455

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Arterial Stiffness Increases With Deteriorating Glucose Tolerance Status – (05-05-03)

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Arterial Stiffness Increases With Deteriorating Glucose Tolerance Status.

More and more evidence is mounting for the contribution that insulin resistance plays in vascular dynamics, both directly and indirectly. Insulin resistance slows the breakdown of ADMA levels, thus blocking nitric oxide’s vasodilatory effects. Hyperinsulinemia lowers contractility of blood vessels. Insulin resistance increases homocysteine levels which then affects formation of plaque on the arterial walls. The list goes on, and one thing is clear–ANY patient with any degree of high blood pressure needs to address the issue of insulin resistance.

Circulation — Abstracts: Henry et al. 107 (16): 2089

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Glucosamine Sulfate May Promote Development of Insulin Resistance – (05-20-00)

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Glucosamine Sulfate May Promote Development of Insulin Resistance

This was a small study, but this will definitely require further studies. Many people continue to take high levels of GS once they have noticed a response. Many times the dosage can be tapered down to much less than the original dosage. If more patients followed this guideline, the risk for increased insulin resistance may turn out to be less. A research study presented at the annual Experimental Biology scientific meetings in San Diego, California, cautioned that consumption of the popular dietary supplement glucosamine sulfate may actually increase the risk of developing insulin resistance and may worsen control of diabetes in patients with this disease. Glucosamine sulfate is widely used to relieve the pain of osteoarthritis and other chronic joint conditions.

Insulin resistance, endothelial dysfunction and essential hypertension – (03-26-01)

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Insulin resistance, endothelial dysfunction and essential hypertension

This study suggests a link between endothelial dysfunction (one of three layers of cells making up the arteries), essential hypertension and insulin resistance. Remember that most cases of high blood pressure are essential/idiopathic, meaning that the cause of the condition is unknown. This study may punch holes in the name “essential” hypertension. Maybe the name should be switched to “insulin resistance hypertension?” So many disease conditions have been linked to insulin resistance that this link should not be a surprise to anyone. The discouraging fact remains that a large portion of today’s diet consists of processed sugars which undeniably can lead to insulin resistance. And, to top off this, insulin resistance (also termed Syndrome X or Metabolic Syndrome) is a largely unrecognized disease state by most physicians.

Synergy : Journal of Internal Medicine 249 (2), 189-197

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Subclinical Glucose Intolerance Increases Risk of Death – (05-03-01)

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Subclinical Glucose Intolerance Increases Risk of Death

Do I need to say any more? Insulin resistance, Syndrome X, metabolic syndrome…whatever you care to call it….is a major risk factor for so many chronic diseases. The sad part is that society is not moving away from refined carbs–a known contributor to insulin resistance. Combine this with the fact that cortisol, the body’s stress hormone, also contributes to insulin resistance, and the increasing incidences of many chronic diseases is no longer a surprise.

Diabetes Care 2001;24:447-453 Subclinical glucose intolerance is associated with an increased risk of death in adults. Dr. Frederick L. Brancati from the Johns Hopkins Medical Institutions in Baltimore, Maryland and colleagues used data from the Second National Health and nutrition Examination Survey Mortality Study to compare mortality among adults with known type 2 diabetes, undiagnosed diabetes and impaired glucose tolerance with adults with normal glucose tolerance. Follow-up lasted 12 to 16 years. Impaired glucose tolerance and undiagnosed diabetes emerged as independent predictors of all-cause mortality and cardiovascular mortality. “There was a gradient of mortality associated with abnormal glucose tolerance ranging from a 40% greater risk in adults with impaired glucose tolerance to a 110% greater risk in adults with clinically evident diabetes,” the investigators report. “These associations were independent of established cardiovascular risk factors.” Early detection and treatment of undiagnosed diabetes and impaired glucose tolerance should help reduce mortality in the US, Dr. Brancati and colleagues conclude.