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Re: Insulin Resistance (LONG, repost of paper)From: paula (anonymous@obgyn.net)Wed, 3 Jan 2001 22:42:49 -0600 (CST)
ok, im going to repost a paper i wrote several months ago about insulin resistance. im hoping it will help explain what it is. low blood sugar is when your glucose (sugar) gets too low. there needs to be a certain amount of it in your blood for daily functions to take place. your body takes food you eat and converts it to glucose that your cells can use for energy. insulin is a hormone produced by the pancreas and its main function is to be a carrier of glucose. this means that insulin picks up glucose that is free floating in the blood and "carrys" it to where it is needed, if it is not currently needed, it is stored as fat. low blood sugar can be caused by several things, but 2 common causes are your body using more glucose than you are consuming or by the production of too much insulin. the insulin has to carry glucose so if there is too much insulin and no glucose is needed for metabolism, the insulin sweeps it (glucose) out of the blood and stores it as fat. high blood sugar is also caused by several different things, but common causes are eating more than you can process or malfunction of the pancreas resulting in poor or no insulin production. diabetes is caused by either the non-production of insulin by the pancreas or poor insulin production. following is the paper, i hope it helps Insulin is a hormone which is produced in an area of the pancreas called the islets of Langerhans. This hormone is essential to the function of the human body. According to an article by Shawn P. Kellerman, “it promotes glucose utilization, protein synthesis, and the formation and storage of neutral lipids by regulating the sugar metabolism of the body” (1). In those people afflicted with Insulin Resistance Syndrome, it is believed that insulin activity breaks down due to a defective gene located on chromosome 19 (Wysong 1). This defect damages insulin receptor sites located throughout the body. The effects of this damage are felt in many different ways. Insulin resistance essentially works like this: the affected individual eats a carbohydrate rich food (such as potatoes, breads, and pastas), carbohydrates are short chain sugars that break down into basic blood sugar in about 30-40 minutes. Once the carbohydrates have been broken down into sugars, the pancreas sends out a copious amount of insulin to store the blood sugars as fat, and since there is now much too much insulin in the blood stream, the blood sugar falls dramatically below a normal level causing hypoglycemia and hunger, even if it has only been an hour since the last meal. The disease progresses to the point where any small amount of carbohydrates taken into the body will cause the pancreas to pour forth with insulin, continuing the cycle. Insulin resistance in women is especially troublesome, and occurs in three stages. Stage one is characterized by increased fasting insulin levels and normal glucose levels. In general, a female in her early 20s, who is otherwise healthy, should have a fasting insulin level of <10. In stage one insulin resistance the fasting level of insulin is generally between 15-25. At this point the disease can usually be controlled by a low-carbohydrate diet. Stage two insulin resistance is characterized by medium to high fasting insulin levels (26-40) and impaired glucose tolerance. This stage of the illness is usually treated by a low-carbohydrate diet and medications that restrict insulin production, such as Glucophage. Finally, Stage three insulin resistance patients may not experience any symptoms due to the fact they are usually full-blown diabetic and glucose levels are controlled by diabetic medications. There are several effects of insulin resistance on the female body, some symptoms are serious, others merely annoying. The main factor in the kind of symptoms a patient experiences is whether or not their insulin production has been askew long enough to cause other hormonal imbalances. In most patients, unfortunately this is the case. Over-production of insulin causes other hormone producing organs, such as the pituitary gland and the ovaries, to also either over-produce or under-produce their respective hormones. Many of the serious effects of insulin resistance come from “side illnesses” or conditions which have the root cause of insulin resistance. The most common illness caused by insulin resistance in women is Polycystic Ovarian Syndrome (PCOS). PCOS is a serious disease with many effects including: chronic fatigue, balance and spatial orientation problems, confusion, hypoglycemic episodes, trouble concentrating, abnormal cholesterol levels, hypertension that is not responsive to conventional medications, hirsutism, obesity, diabetes, lack of menstrual cycles, and anovulation, causing infertility (Insulin Resistance...). Other illnesses caused by insulin resistance include: irritable bowel syndrome, vulvodynia, and chronic migraine headaches. The merely “annoying” symptoms of insulin resistance are generally cosmetic, but can result in severe social consequences. These effects include: hirsutism (facial and body hair in overabundance), obesity, severe acne, acanthosis nigracans (darkening of skin giving the appearance of dirt), and male pattern hair loss. Picture a 20 year old female who weighs 300 pounds, has very little hair on her head, an overabundance of hair elsewhere on her body, and dark patches of skin on her neck, knees, knuckles, and elbows. This is what women with insulin resistance must deal with. While insulin resistance ia a syndrome, and not all women with it are suffering from all of the symptoms, many are affected by all of them. Diagnosing insulin resistance early is the key component to effective treatment. According to the Insulin Resistance Information Page, “The disease can be deceptive in diagnosis, and frankly many doctors are unwilling to search for the cause of a fat women’s problem with weight when it is much easier to claim the problem is self-induced” (3). This indeed seems to be true. Insulin resistance can sometimes be diagnosed by a simple fasting insulin and glucose test, however many times these tests are influenced by the previous day’s food choices and can come back as normal. When these tests come back with results that are in the “normal” range, and the patient has symptoms of insulin resistance, an Insulin-glucose-tolerance-test (IGTT) should be ordered. This test is generally 2-5 hours long and involves taking blood samples every 10-30 minutes to determine and map the dips and spikes in both insulin and glucose levels. Once a diagnosis is made and the stage of the illness is determined, it is time to pursue treatment. Depending on whether a patient is afflicted with PCOS or not, the treatment may or not include fertility treatments. If the patient does not desire a pregnancy at the time, treatment should include a low-carbohydrate diet, medications to control symptoms, and an exercise regimen. Treatment also depends on the doctor treating the illness. Many doctors are now prescribing medications such as Glucophage (formerly used exclusively for diabetes, this drug has shown to lower insulin levels), spirolactone (used to suppress body hair and stimulate scalp hair), and provera (a hormone used to promote menstruation). Insulin Resistance and its effects on women is a serious concern. It is the root cause of many illnesses, and is easily treatable once diagnosed. Doctors must overcome their assumptions and stereotypes regarding obesity, and step up to find the cause. Continuing research should enable us to successfully treat and eliminate the effects of this disease in the near future. hope this is helpful =) love, paula
-- feel free to email me anytime at paulam74@hotmail.com
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