Lecture on Diabetes and Insulin Resistance

Key Points

• Diabetes as a Cause of Death:

  • Diabetes often exacerbates or causes other conditions rather than being a direct cause of death.
  • It is linked to numerous disorders, including heart disease and cancer.

• Metabolic Health in the U.S.:

  • Study from 2019 indicates only 12% of U.S. adults are metabolically healthy.
  • Metabolic health is defined by waist circumference, blood pressure, and blood levels of HDL, cholesterol, triglycerides, and glucose.

Insulin Resistance

• Definition and Function:

  • Insulin is a hormone produced by the pancreas; it acts by binding to insulin receptors on every cell.
  • Main function is to lower blood glucose by allowing glucose to enter cells.
  • Over time, insulin action can diminish, leading to insulin resistance.

• Characteristics of Insulin Resistance:

  • Diminished cellular action in response to insulin.
  • Elevated blood insulin levels (hyperinsulinemia).
  • Normal glucose levels initially, but more insulin is required to maintain this.

Metabolic Syndrome and Insulin Resistance

• Five Aspects:

  • Glucose levels: Chronic high glucose leads to type 2 diabetes.
  • Waist circumference: Insulin affects metabolic rate and body fat.
  • Blood pressure: Linked to aldosterone, which retains salt and water, raising blood pressure.
  • Triglycerides and HDL cholesterol: Indicators of insulin sensitivity.

• Broader Disease Implications:

  • Insulin resistance is linked to diabetes, heart disease, cancer, Alzheimer's, stroke, arthritis, migraines, infertility, and fatty liver disease.

Insulin Levels and Therapy

• Insulin as a Key Marker:

  • Insulin levels rise much earlier in life than glucose levels during progression to type 2 diabetes.
  • Elevated insulin levels can be an early indicator of metabolic syndrome.

• Implications of Insulin Therapy:

  • Insulin therapy can lead to weight gain, increased risk of heart disease, and cancer.
  • Important to manage insulin levels to prevent these risks.

Recommendations

• Insulin Levels:

  • Ideal insulin level should be around 6 microunits per ml.
  • Average American levels (~9 microunits per ml) are higher than ideal.

• Dietary Strategy:

  • Low-carb diets are recommended for managing insulin resistance and metabolic health.

Conclusion

• Understanding and managing insulin resistance is crucial in addressing metabolic syndrome and related chronic diseases.